脑挫裂伤患者早期心肌酶测定的临床意义  

Clinical Significance of Early Cardiac Enzymes Determination of Brain Contusion

作　　者：陶元丰[1] 杨兰[1] Tao Yuanfeng Yang Lan(The First Department of Neurology of The Second Division Korla Hospital of Xinjiang Production and Construction Corps,Xinjiang, Kada,841000)

机构地区：[1]新疆生产建设兵团第二师库尔勒医院神经一科,新疆库尔勒841000

出　　处：《新疆医学》2016年第11期1437-1439,共3页Xinjiang Medical Journal

摘　　要：目的探讨脑挫裂伤患者早期测定心肌酶对伤情及预后判断的意义。方法78例脑挫裂伤患者，根据入院时格拉斯哥昏迷评分标准（Gcs）评分，分为轻中度组（9-15分）和重型组（3-8分）；依据头颅CT扫描结果，分为单纯脑挫裂伤组（治疗组1）和合并颅内血肿组（治疗组2）；根据格拉斯哥预后评分标准（60s）对预后评定，分预后优良组（4-5分）和预后不良组（1-3分）。入院24小时内测定：谷草转氨酶（AST）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）。50例同期健康体检者为对照组，将测定值进行对比分析。结果脑挫裂伤患者的心肌酶均高于对照组（P〈O．01）；重型脑挫裂伤患者心肌醇水平高于轻、中型患者（P〈Om5）；合并颅内血肿脑挫裂伤患者心肌酶水平高于单纯脑挫裂伤患者（P〈0．05）；预后不良患者的心肌酶水平高于预后良好的患者（P〈0．05）。结论脑挫裂伤患者早期心肌酶值升高，与脑挫裂伤严重程度、是否合并颅内血肿及预后均有关，早期检查心肌酶可作为伤情及预后的判断标准。Objective To Discuss the significance of early brain contusion in patients with cardiac enzymes determination and prognosis of injured. Methods 78 cases of patients with cerebral contusion, according to admission Glasgow Coma score, were divided into the mild and moderate groups （9-15 points） and the severe group （3-8 points）; which based on head CT scan results,were divided into the simple brain contusion group（the treatment group 1） and the intracranial hematoma group （the treatment group 2）; according to Glasgow outcome score （GOS） for the prognosis assessment,were divided into the good prognosis sub group （4 to 5 minutes） and the poor prognosis group（1 to 3 points）. Aspartate aminotransferase（AST）, creafine kinase（CK）, creatine kinase（CK-MB）, lactate dchydrogenase（LDH） were measyred in 24 hours. 50 cases of healthy volunteers as the control group,and the measured values were analyzed. Results Cerebral contusion patients with cardiac enzymes were higher than that of the control group （P 〈0.01）; enzyme levels in patients with severe brain contusion were higher than that of the mild and moderate patients （P〈0.05）; cardiac enzyme levels of cerebral contusion patients with intracranial hematoma were higher than that of the patients with simple brain contusion patients （P〈0.05）; cardiac enzyme levels of patients in the poor prognosis were higher than that of the good prognosis （P 〈0.05）. Conclusion Elevated cardiac enzymes in patients with early brain contusion, brain contusion severity of a merger of intracranial hematoma and prognosis are related, enzymes can be used as early detection and prognosis of the injury criteria.

关 键 词：脑挫裂伤 心肌酶 

分 类 号：R4[医药卫生—临床医学]