创伤失血性休克患者血清一氧化氮水平变化及其临床意义研究  

Changes in serum levels and the clinical significance of NO in post traumatic patients with hypovolemic shock

作　　者：王占科[1] 王白岚[1] 陈自力[2] 崔晓辉[1] 吴豫[1] 

机构地区：[1]解放军第九四医院检验科,南昌330002 [2]解放军第九四医院创伤急救中心,南昌330002

出　　处：《急诊医学》2000年第6期382-384,共3页

摘　　要：目的 :探讨创伤失血性休克患者一氧化氮 (NO)的代谢及在休克中的作用机制 ,为临床治疗提供理论依据。方法 :采用镉还原Griess重氮试剂法 ,检测 110例创伤失血患者血清NO水平 ,并与患者预后、动脉舒张压、收缩压及外周全血象进行相关分析。结果 :创伤失血性休克患者血清NO水平 (41 86± 9 83μmol/L)比正常对照组 (17 5± 6 2 4μmol/L)明显升高 (P<0 0 5 ) ,并与疾病的严重程度明显相关 (P <0 0 5 )。NO水平与外周血红蛋白含量 (r =-0 6 0 32 ,P <0 0 5 ) ,收缩压水平 (r =- 0 8731,P <0 0 1) ,舒张压水平 (r =- 0 76 45 ,P <0 0 1)呈负相关 ,与外周血中性粒细胞数量 (r =0 86 6 7,P <0 0 1)呈正相关 ,与外周血小板数量 (r =0 40 5 1,P >0 0 5 )相关不显著。结论 :NO在创伤失血性休克病理生理过程中发挥重要作用。血清NO水平变化可作为判断失血性休克患者预后转归的有效指标。Objective:In order to illustrate the changes of serum levels of NO and its roles on the mechanisms of hypovolemic shock caused by trauma.Methods:Using the method described by Griess,the serum levels of NO in 110 cases of post traumatic patients are measured,and correlations between the serum level of NO,the systolic and diastolic blood pressure,the complete blood count,and the severity of illness are analyzed.Results:The serum levels of NO of trauma groups(41 9±9 8μmol/L)are significantly higher than the normal group(17 5±6 3μmol/L).The serum level of NO of trauma and shock group(42 78±10 7μmol/L) is significantly higher than trauma group(24 5±5 9μmol/L),which is significantly lower than that of the trauma and shock and dead group(58 4±14 5μmol/L).It has been observed that there are significant correlations between the NO and the systolic and diastolic pressure(r= -0 8731, -0 7645),haemoglobin(r=-0 6032),leucocyte count(r=0 8667).However,there is significant correlation between the serum level of NO and the platelet count.Conclusion:The serum NO plays an important role in mechanisms of hypovolemic shock caused by trauma.Measuring the serum level of NO would contribute to diagnosis and estimation of hypovolemic shock caused by trauma.

关 键 词：创伤 失血性休克 一氧化碳 临床意义 

分 类 号：R605.971[医药卫生—急诊医学]