肾上腺髓质素前体中段肽在多发伤患者中的应用分析  

Analysis of the application of mid-regional pro-adrenomedullin in multiple trauma

作　　者：周峰[1] 刘志祯[1] 蔡华忠[1] 苗振军[1] 魏法星[1] ZHOU Feng;LIU Zhizhen;CAI Huazhong;MIAO Zhenjun;WEI Faxing(Department of Emergency,the Affliated Hospital of Jiangsu Univesity,Jiangsu,Zhenjiang,212001,China)

机构地区：[1]江苏大学附属医院急诊科,江苏镇江212001

出　　处：《临床急诊杂志》2018年第7期440-442,共3页Journal of Clinical Emergency

基　　金：镇江市社会发展项目(No:SH2017025)

摘　　要：目的:探讨血清肾上腺髓质素前体中段肽(MR-proADM)对多发伤患者病情评估的应用价值。方法:检测我院100例多发伤患者和30例对照组的血清MR-proADM,并对多发伤患者进行入院的AIS-ISS评分。比较多发伤组与对照组的血清MR-proADM,并比较死亡组与生存组、重伤组和严重伤组的血清MR-proADM及AIS-ISS评分,将多发伤患者血清MR-proADM及AIS-ISS评分进行相关性分析。采用受试者工作曲线(ROC)进行血清MR-proADM及AIS-ISS评分在多发伤患者预后分析。结果:(1)死亡组患者的MR-proADM及AISISS评分明显高于生存组(P<0.01),严重伤组的MR-proADM及AIS-ISS评分高于重伤组(P<0.01);血清MR-proADM与AIS-ISS评分呈正相关(r=0.661,P<0.01);(2)MR-proADM的AUC为0.817,95%可信区间为0.729~0.905,AIS-ISS评分AUC为0.786,95%可信区间0.683~0.888;(3)ROC曲线中,MR-proADM截断值为2.91,敏感度0.760,特异度0.784,AIS-ISS评分截断值36,敏感度0.684,特异度0.732。结论:多发伤患者血清MR-proADM水平升高,且水平随着伤情加重而上升,检测MR-proADM对多发伤患者预后评估有一定的应用价值。Objective：To explore the application value of serum mid-regional pro-adrenomedullin in the assessment of patients with multiple trauma.Method：The serum MR-proADM levels of 100 cases of multiple trauma patients and 30 cases in control group in our hospital were measured and the AIS-ISS score of the multiple trauma patients was evaluated.The serum MR-proADM levels of the multiple trauma group and the control group were compared.The serum MR-proADM and AIS-ISS scores of the death group,the survival group,the serious injury group and the more serious injury group were compared.The correlation between serum MR-proADM and AIS-ISS scores of the multiple trauma patients was analyzed.The outcome of serum MR-proADM and AIS-ISS scores in multiple trauma patients was analyzed with the subjects working curve（ROC）.Result：（1）The scores of MRproADM and AIS-ISS in the death group were significantly higher than those in the survival group（P〈0.01）,MR-proADM and AIS-ISS in the more serious injury group were higher than those in the serious injury group（P〈0.01）,and MR-proADM was positively correlated with the AIS-ISS score（r=0.661,P〈0.01）;（2）Under the ROC curve,the AUC of MR-proADM is 0.817,the 95%confidence interval is 0.729-0.905,the AUC of AIS-ISS score is 0.786,and the 95% confidence interval 0.683-0.888;（3）In the ROC curve,the truncated value of MRproADM was 2.91,the sensitivity was 0.760,the specificity was 0.784,the truncated value of AIS-ISS score was36,the sensitivity was 0.684,and the specificity was 0.888.Conclusion：The level of MR-proADM in patients with multiple injury was elevated,which increased with the severity of the injury.The detection of MR-proADM had a certain value in the evaluation of the prognosis of patients with multiple trauma.

关 键 词：肾上腺髓质素前体中段肽 多发伤 预后 

分 类 号：R641[医药卫生—外科学]