交通伤患者早期血浆肾上腺髓质素含量变化对血流动力学的影响  

Effect of change of plasma adrenomedullin concentration on hemodynamics in patients injured by traffic accidents in early stage

作　　者：周华满[1] 顾向明[2] 缪英年[1] 程少华[1] 刘国奋[1] 欧武剑[1] 

机构地区：[1]广州中医药大学附属中山市中医院急诊科急创组,广东省中山市528400 [2]广州中医药大学附属中山市中医院检验科,广东省中山市528400

出　　处：《实用医学杂志》2005年第23期2636-2638,共3页The Journal of Practical Medicine

摘　　要：目的:探讨交通事故伤伤员早期血浆肾上腺髓质素(ADM)含量变化,并初步分析其对血流动力学的影响。方法:用放射免疫分析法测定64例交通伤伤员及30例正常健康人血浆ADM含量,并分别与平均动脉压(MAP)、心率(HR)、损伤严重度评分(ISS)进行相关性分析。结果:交通伤伤员早期血浆ADM含量为(37.27±11.70)ng/L,显著高于正常对照组(20.20±3.45)ng/L(P<0.01),重伤组为(42.82±11.70)ng/L,明显高于轻伤组(31.71±8.28)ng/L(P<0.01);血浆ADM含量分别与MAP(r=0.4617)、HR(r=0.4591)、ISS(r=0.6410)均呈正相关性(P<0.01)。结论:血浆ADM含量增高可能是交通伤早期血管活性肽的一种代偿性自身调节机制,并对机体血流动力学变化产生一定的影响。因此,血浆ADM含量测定可为交通伤血管活性肽的临床研究提供一个新指标。Objective To explore the role of the change of plasma adrenomedullin （ADM） concentration in patients injured by traffic accidents in the early stage and to analyze the effect of change of plasma ADM on the hemodynamics. Methods The plasma ADM concentration was measured by radio immunoassay in 64 patients injured by traffic accidents and 30 age-sex-matched healthy persons. And the relationships between plasma ADM and mean arterious pressure （MAP）, heart rate （HR） and injury severity score （ISS） were revealed separately. Results The plasma ADM concentration of traffic trauma patients in the early stage was markedly higher than that in normal control group[ （37.27 ± 11.70）ng/L vs （20.20 ± 3.45）ng/L, P 〈 0. 01 ]. Plasma ADM of serious trauma group was significantly higher than that of mild trauma group [（42. 82 ± 11.70） ng/L vs （31.71±8.28） ng/L, P 〈 0.01] . The dramatically affirmative correlations existed separately between increased plasma ADM and raised MAP （r = 0.4617 ）, added HR （r = 0.4591 ）and gained ISS（ r = 0.6410） （ P 〈 0.01 ）. Conclusion Increased plasma ADM concentration may be a possible mechanism of compensational self-regulation for vascular active peptides in traffic trauma patients in the early stage, and there may be a certain effect on the hemodynamics of the body. It might be used as a new parameter on clinical study of vascular active peptides during traffic injury.

关 键 词：创伤和损伤 事故 交通 肾上腺髓质 血流动力学 

分 类 号：R641[医药卫生—外科学]