多发伤合并肺挫伤患者CD36和CD63水平及其与血管内皮损伤关系的研究  

Study on the levels of CD36 and CD63 and their relationship to the vessel endothelial injury in patients suffering from combined multiple trauma with pulmonary contusion

作　　者：孙海伟[1] 陆骏灏[2] 赵益明[3] 吉美霞[1] 陈中珍[1] 王卫广[1] 李军根[1] 李永存[1] 陆士奇[1] 

机构地区：[1]苏州大学附属第一医院急诊科,江苏苏州215006 [2]吴江市第一人民医院急诊科 [3]苏州大学附属第一医院血栓研究室

出　　处：《中国急救医学》2012年第6期506-509,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨多发伤合并肺挫伤患者急性期和恢复期血小板CD36和CD63水平变化及其与内皮损伤的关系，并探讨其临床应用价值。方法选择2008-06-2011-11收入我院急诊科的多发伤合并肺挫伤患者50例，包括男28例，女22例，年龄（32．3±11．5）岁。按创伤严重度评分（ISS）分为重伤组（ISS≥16分，29例）和轻伤组（ISS〈16分，21例）；按ARDS诊断标准，分为ARDS组（27例）和非ARDS组（23例）；按预后分为生存组（36例）和死亡组（14例）。同时取15例健康人作为对照组，其中男8例，女7例，年龄（33．5±10．6）岁。各组性别和年龄构成均具有可比性。患者到达急诊科后6h内抽取外周静脉血2mL。应用流式细胞仪检测血小板CD36和CD63双阳性率，同时采用ELISA技术检测外周静脉血m浆血管性血友病因子（vwF）的水平。结果血小板CD36和CD63双阳性率、血浆vwF水平重伤组明显高于轻伤组（P〈0．05），ARDS组明显高于非ARDS组，死亡组明显高于生存组（P〈0．05）。创伤后血小板CD36和CD63的水平与血管内皮损伤指标（vWF）有明显的相关性（P〈0．05）。结论血小板CD36和CD63双阳性率在多发伤合并肺挫伤早期明显增高，和创伤严重程度相关，同时反映了患者肺损伤的程度，这对多发伤合并肺挫伤，特别是并发急性呼吸窘迫综合征（ARDS）的诊断和预后预测具有重要的临床价值。Objective To investigate the early levels of CD 36 and CD63 in patients with multiple trauma and severe pulmonary contusion and their relationship to the endothelial injury and their clinical significance. Methods Patients with multiple trauma and pulmonary contusion admitted to the emergency department of the first affiliated hospital of Sooehow University from June 2008 to November 2011 were enrolled. A total of 50 casualties met the criteria （ admission within I day ＇after trauma and age 〉 18 years）, and were eligible for enrollment. Patients are free of heart, brain, liver, kidney and other organic diseases, diabetes, hypertension, tumor, acute and chronic infectious diseases. Among the 50 patients,28 were males and 22 females. The average age was （32.3± 11. 5 ）years. Patients were divided into severe trauma group （ISS≥ 16 points, n = 29） , moderate trauma group （ISS 〈 16 points, n =21 ）judged by using injury severity score （ISS） ;divided into ARDS group and no- ARDS group judged by the diagnostic criteria of ARDS; divided into survival group and no - survival severe trauma group judged by prognosis. Fifteen healthy subjects were selected as controls, 8 male and 7 female, with age 〉 18 years and all average age of （33.5± 10.6 ）years. All groups had comparable gender proportionand average age. The 2 ml peripheral blood sample was collected within 10 minutes after arrival of patients to emergency department and the plasma was separated from blood. Enzyme - linked immunosorbent assay （ELISA） was used to detect the plasma levels of yon Willebrand factor （vWF） and the serum levels of CD36 and CD63 were detected by flow cytometry. Data was analyzed by using SPSS version 17.0 statistical software. Results The serum levels of CD36 and CD63 and the plasma levels of vWF in severe trauma group （ISS score 16 points） were significantly higher than those in moderate trauma group （ISS 〈 16 points）（P 〈0.05）, and those in trauma patients of these two groups were both

关 键 词：多发伤 肺挫伤 血管性血友病因子(vWF) CD36 CD63 

分 类 号：R543[医药卫生—心血管疾病]