肿瘤坏死因子-α、内毒素、血小板活化因子与重症胸腹损伤后凝血功能障碍的相关性研究  

Relationship of tumor necrosis actor-α,lipopolysaccharide and platelet-activating factor with coagulation disorders after severe chest-abdomen injury

作　　者：李志伟[1] 董浩[1] 代文光[1] 郭雅琼[1] 赵立强[1] 王树龙[1] 乔帅[1] 梁永刚[1] 高文华[1] 徐旭[1] 

机构地区：[1]解放军253医院急诊科,内蒙古呼和浩特010051

出　　处：《西北国防医学杂志》2015年第5期285-287,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:探讨肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、血小板活化因子(PAF)与重症胸腹损伤后凝血功能障碍的相关性。方法:112例重症胸腹损伤患者的创伤指数(TI)≥17分,检测血小板(PLT)、血浆D-二聚体(D-D)、部分活化凝血酶原时间(APPT)、TNF-α、LPS、PAF,对检验结果进行相关性分析。结果:PLT:(73.14±32.59)×109/L,D-D:(1 893.87±508.72)U/L,APTT:(78.29±14.52)s。TNF-α:(39.61±13.09)ng/ml,LPS:(453.68±96.37)IU/L,PAF:(15 969.31±4 031.65)ng/L。PLT与TNF-α、LPS、PAF之间相关系数r均<-0.8951,显著负相关。D-D、APTT与TNF-α、LPS、PAF之间r均>0.9307,显著正相关。结论:TNF-α、LPS、PAF可能参与了胸腹创伤后凝血功能障碍的发生,早期干预可能改善重症胸腹创伤患者的凝血功能障碍。Objective： To investigate the correlation of tumor necrosis factor-α （TNF-α）, lipopolysaccharide（LPS） and platelet-αctivating factor （PAF） with the blood coagulation function disorder after severe chest-αdomen injury. Methods：A total of 112 patients with severe chest-αdomen injury were collected, with the trauma index ≥17. The platelet count （PLT） ,D--dimer （D--D） ,activated partial thromboplastin time （APTT）, TNF-α LPS and PAF were detected and analyzed statistically. Results：The PLT,D--D and APTT were （73. 14±32.59） ×109/L, （1 893.87±508. 72）U/L, （78. 29_＋ 14.52）s,and the TNF-α, LPS and PAF were （39. 61 ± 13. 09） ng/ml, （453. 68±96. 37） IU/L, and （15 969.31± 031.65）ng/L. The negative correlation was found between PLT and TNF-αLPS and PAF （r〈-0. 8951） ,and the positive correlation was noticed between D--D,APTT and TNF-αLPS and PAF （r〉0. 9307）. Conclusion： The TNF-α LPS and PAF may all participate in the process of the blood coagulation function disorder after severe chest-αdomen injury. The early intervention may improve the coagulation dysfunction of patients with severe chest-αbdomen injury.

关 键 词：重症胸腹损伤 凝血功能障碍 肿瘤坏死因子-Α 内毒素 血小板活化因子 

分 类 号：R641[医药卫生—外科学]