摘要
目的研究外周血转化生长因子β1(TGF-β1)与多发伤患者伤情严重程度及并发症的相关性。方法选取2012年1月—2017年1月西安高新医院收治的96例多发伤患者作为研究对象,根据患者创伤轻、中、重程度将其分为3组采用回顾性分析法分析所有患者的临床资料,记录所有患者其性别、年龄及病情程度等一般临床资料和TGF-β1等相关临床指标水平以及并发症的发生情况,并比较3组患者不同病情严重程度患者间上述资料,分析TGF-β1与患者病情严重程度的关系以及影响并发症发生的相关因素。结果 3组患者在TGF-β1、C-反应蛋白(CRP)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)和中性粒细胞与淋巴细胞比值(NLR)水平的比较,差异有统计学意义,且重度创伤患者其上述指标水平较轻、中度创伤患者升高(P<0.05);经Spearman等级相关分析得TGF-β1、CRP、IL-1β、IL-6和NLR均与ISS评分呈正相关(P<0.05);重度多发伤患者其多器官功能衰竭和病死率高于轻度和中度创伤患者(P<0.05);经非条件单因素Logistic回归模型分析可得,并发症患者与未发生并发症患者间其多发伤严重程度及TGF-β1、CRP、IL-1β、IL-6和NLR水平差异均有统计学意义(P<0.05);经非条件多因素Logistic回归模型分析进一步证实得,重度多发伤以及TGF-β1、IL-1β和NRI升高均为导致多发伤患者并发症发生的独立危险因素(P<0.05)。结论 TGF-β1表达水平与多发伤病情严重程度呈正相关,且为导致多发伤患者并发症发生的独立危险因素,故临床上可将该指标作为评估多发伤患者病情进展和预后的有效指标之一。
Objective To study the relationships between peripheral blood transforming growth factor-β1(TGF-β1),severity of injury and complications in patients with multiple traumas.Methods Between January 2012 and 2017,96 cases of multiple trauma patients treated in our hospital were selected as the subjects,who were divided into three groups based on degrees of trauma(mild,moderate and severe).The clinical data of all these patients was analyzed retrospectively.The patients'clinical data(gender,age and severity of disease),TGF-β1,other related clinical indicators and complications were recorded and compared between the three groups.The relationships between TGF-β1,severity of the disease and related factors affecting the occurrence of complications were analyzed.Results There was significant difference in TGF-β1,CRP,IL-1β,IL-6 and NLR levels between the three groups.These levels increased significantly in patients with severe trauma index compared with mild and moderate trauma patients(P<0.05).By Spearman rank correlation analysis,TGF-beta 1,CRP,IL-1 beta,IL-6 and NLR were positively correlated with the ISS score(P<0.05).The incidence of multiple organ failure and death in severe multiple trauma patients was significantly higher than that in mild and moderate trauma patients(P<0.05).According to single factor non-conditional logistic regression analysis,there was statistically significant difference between patients with complications and those without any complications in severity of the disease and levels of TGF-β1,CRP,IL-1β,IL-6 and NLR(P<0.05).Multi-factor non-conditional logistic regression analysis showed that severe multiple trauma and increased levels of TGF-β1,IL-1βand NRI were leading independent risk factors for complications among patients with multiple injuries(P<0.05).Conclusion The expression level of TGF-β1 is positively correlated with the severity of multiple injuries,and is an independent risk factor for the occurrence of complications in patients with multiple injuries.Therefore,this index can be used as an effective index to evaluate the progression and prognosis of patients w ith m ultiple traumas.
作者
王鹏
吴喆
雷志刚
WANG Peng;WU Zhe;LEI Zhigang(Department of Emergency, Xi'an Gaoxin Hospital, Xi'an 710075, China)
出处
《空军医学杂志》
2018年第6期387-390,共4页
Medical Journal of Air Force
基金
陕西省科技厅社会发展攻关资助项目(2012SF2-22)
关键词
外周血转化生长因子-β1
多发伤
疾病严重程度
并发症
创伤程度
peripheral blood transforming growth factor-β1
multiple injury
severity of disease
complications
degree of trauma
