创伤患者可溶性P选择素与血管性血友病因子的水平变化  

Change of soluble P-selectin and von Willebrand factor levels in traumatic patients

作　　者：潘莹莹[1] 陈莹莹 张碧玉[1] 唐宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030 [2]襄阳中医院检验科,湖北襄阳441000

出　　处：《国际检验医学杂志》2014年第14期1833-1835,1838,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨创伤患者血浆可溶性P选择素(sPsel)和血管性血友病因子(vWF)的入院后水平变化情况,及其与凝血指标水平、凝血障碍和预后的关系。方法前瞻性地选取该院ICU病房82例严重创伤患者,入院时及入院后第1周内每日检测患者血浆中sPsel、vWF抗原、蛋白C、凝血因子Ⅶ活性及常规凝血指标,并记录患者入院30d病死率。结果有凝血障碍创伤患者的入院时sPsel和vWF水平均低于无凝血障碍的患者(P<0.05),且与各凝血指标(蛋白C和Ⅶ因子)水平均显著相关(P<0.05)。死亡患者vWF水平在入院后前3天显著低于生存患者(P<0.05),而在入院后第7天显著高于生存患者(P<0.05);未发现生存患者与死亡患者间入院后1周内sPsel水平有明显不同。结论在ICU严重创伤患者中,入院时低水平的sPsel和vWF水平与凝血障碍相关,vWF水平在入院后第7天显著升高与患者30d病死率增高相关。Objective To investigate the change of soluble P-selectin （sPsel）and von Willebrand factor （vWF）levels after ad-mission in traumatic patients and their relation with the coagulation indexes levels,coagulation disorders and prognosis.Methods 82 cases of severe trauma in ICU of Affiliated Tongji Hospital were prospectively selected and detected plasma sPsel,VWF anti-gen,protein C,activity of coagulation factor Ⅶ and routine coagulation indexes on admission and on every day within the first week after admission.The 30 d fatality rate was recorded.Results The sPsel and vWF levels on admission in the patients with coagula-tion disorders were lower than those in the patients without coagulation disorders （P 〈0.05）and significantly correlated with the coagulation indexes （protein C and coagulation factor Ⅶ）levels （P 〈0.05）.The vWF level within 3 d after admission in the death patients was significantly lower than that in the survival patients,but which on 7 d after admission in the death patients was signifi-cantly higher than that in the survival patients （P 〈0.05 ）;no significant difference in sPsel level within 1 week after admission were found between the survival patients and the death patients.Conclusion Among severe traumatic patients in ICU,the low lev-els of sPsel and VWF on admission are associated with the coagulation disorders,the significant rise of vWF level on 7 d after ad-mission is associated with the increase of the 30 d fatality rate.

关 键 词：重症监护病房 可溶性P选择素 血管性血友病因子 

分 类 号：R641[医药卫生—外科学]