高海拔地区严重创伤患者血清免疫球蛋白及C反应蛋白的变化及意义  

Change and significance of serum immunoglobulin and C reactive protein in patients with severe trauma in high plateau

作　　者：钱惠岗[1] 樊建林[1] 公保才旦[1] 陈元清[1] 

机构地区：[1]青海省人民医院急救中心,青海西宁810007

出　　处：《中国医药导报》2015年第28期47-50,共4页China Medical Herald

基　　金：青海省(应用)基础研究计划项目(2013-Z-742)

摘　　要：目的探讨高海拔地区严重创伤患者血清免疫球蛋白及C反应蛋白（CRP）的变化及临床意义。方法选择2010年1月-2014年12月在青海省人民医院急诊科住院的严重创伤患者30例,按是否并发多器官功能障碍综合征（MODS）,分为MODS组（16例）和非MODS组（14例）;另选10例健康体检者作为健康组。采用速率散射免疫比浊法及透射免疫比浊法测定血清免疫球蛋白及CRP水平,动态观察MODS组和非MODS组入院时及术后2、4、6、8、14 d的血清免疫球蛋白与CRP水平,与健康组进行比较。结果与健康组比较,非MODS组入院时免疫球蛋白水平明显降低,CRP水平明显升高,术后14 d免疫球蛋白水平明显升高（P〈0.01）;与健康组比较,MODS组入院时及术后2、4、6、8 d免疫球蛋白水平降低,CRP水平升高,术后14 d免疫球蛋白及CRP水平升高（P〈0.05或P〈0.01）。非MODS组与MODS组术后8、14 d的免疫球蛋白及CRP水平比较,差异有统计学意义（P〈0.05或P〈0.01）。结论血清免疫球蛋白及CRP水平变化可作为严重创伤后的预警因子,动态观察有助于病情评估。Objective To investigate the change and clinical significance of serum immunoglobulin and C reactive protein（CRP） in patients with severe trauma in high plateau. Methods 30 cases of patients with serve trauma treated in Department of Emergency, People′s Hospital of Qinghai Province from January 2010 to December 2014 were selected,according to whether complicated with multiple organ dysfunction syndrome（MODS）, they were divided into MODS group（16 cases） and non-MODS group（14 cases）. Another 10 healthy subjects were selected as health group. Serum immune globulin and CRP levels were tested by rate scatter immune turbidimetric method, serum immune globulin and CRP levels of MODS group and non-MODS group on admission and after operation of 2, 4, 6, 8, 14 d were observed dynamicly and compared with those of health group. Results Compared with healthy group, the level of immunoglobulin in non-MODS group on admission was significantly decreased, CRP level was significantly elevated, the level of immunoglobulin in 14 d after operation was significantly higher（P〈0.01）. Compared with healthy group, levels of immunoglobulin in MODS group were decreased on admission and postoperative 2, 4, 6, 8 d, CRP level was increased,immunoglobulin and CRP levels were increased on postoperative 14 d（P〈0.05 or P〈0.01）. Immunoglobulin and CRP levels of MODS group and non-MODS group in 14 d after operation were compared, with statistical differences（P〈0.05 or P〈0.01）. Conclusion The changes of serum immune globulin and CRP levels can be used as an early warning factor after severe trauma, and dynamic observation is helpful to the assessment of patient′s condition.

关 键 词：高原 创伤 免疫球蛋白 C反应蛋白 

分 类 号：R641[医药卫生—外科学]