肿瘤坏死因子-α、高速泳动族蛋白B1及超敏C反应蛋白与急性创伤患者发生创伤性凝血病的关系  

Association of tumor necrosis factor-α, high mobility group box-1 protein, and high sensitivity C-reactive protein with trauma-induced coagulopathy in patients

作　　者：杨延红 乐欢[2] 秦勇[1] YANG Yanhong;YUE Huan;QIN Yong(Department of Emergency,Fuling Hospital Affiliated to Chongqing University,Chongqing408000,China;the First Department of Orthopaedics,Fuling Hospital Affiliated to Chongqing University,Chongqing408000,China)

机构地区：[1]重庆大学附属涪陵医院急救部,重庆408000 [2]重庆大学附属涪陵医院骨一科,重庆408000

出　　处：《中国医药导报》2023年第10期88-91,共4页China Medical Herald

基　　金：重庆市科卫联合医学科研项目(2020FYYX010)。

摘　　要：目的探究肿瘤坏死因子-α(TNF-α)、高速泳动族蛋白B1(HMGB1)及超敏C反应蛋白(hs-CRP)与急性创伤患者发生创伤性凝血病(TIC)的关系。方法选取2020年7月至2022年7月重庆大学附属涪陵医院收治的急性创伤患者120例,根据是否发生TIC将其分为TIC组(39例)和非TIC组(81例)。比较两组临床资料的差异,采用多因素logistic回归模型分析TNF-α、HMGB1和hs-CRP与TIC发生的关系,绘制受试者操作特性(ROC)曲线评价TNF-α、HMGB1和hs-CRP对TIC发生的预测价值。结果TIC组损伤严重度评分(ISS)、休克指数(SI)、TNF-α、HMGB1和hs-CRP水平均高于非TIC组(P<0.05)。多因素分析显示,SI(OR=1.545,95%CI:1.100~2.170)、TNF-α(OR=1.021,95%CI:1.008~1.034)、HMGB1(OR=1.068,95%CI:1.025~1.113)、hs-CRP(OR=1.047,95%CI:1.012~1.083)是TIC发生的影响因素(P<0.05)。ROC曲线分析显示,TNF-α、HMGB1、hs-CRP联合预测TIC发生的曲线下面积为0.900,灵敏度为0.923,特异度为0.753。结论TNF-α、HMGB1和hs-CRP是影响患者发生TIC的影响因素,可作为TIC早期筛查的血清生物学标志物。Objective To investigate the association between tumor necrosis factor-α(TNF-α),high mobility group box-1 protein(HMGB1),and high sensitivity C-reactive protein(hs-CRP)with trauma-induced coagulopathy(TIC)in patients.Methods A total of 120 patients with acute trauma admitted to Fuling Hospital Affiliated to Chongqing University from July 2020 to July 2022 were selected and divided into TIC group(39 cases)and non-TIC group(81 cases)according to the incidence of TIC.The difference of clinical data between the two groups was compared.Multivariate logistic regression model was used to analysis the relationship between TNF-α,HMGB1,and hs-CRP and the occurrence of TIC.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of TNF-α,HMGB1,and hs-CRP for the occurrence of TIC.Results The injury severity score(ISS),shock index(SI),and levels of TNF-α,HMGB1,hs-CRP in TIC group were higher than those in non-TIC group(P<0.05).Multivariate analysis showed that SI(OR=1.545,95%CI:1.100-2.170),TNF-α(OR=1.021,95%CI:1.008-1.034),HMGB1(OR=1.068,95%CI:1.025-1.113),hs-CRP(OR=1.047,95%CI:1.012-1.083)were the influencing factors of TIC occurrence(P<0.05).ROC curve analysis showed that the area under the curve of TNF-α,HMGB1,and hs-CRP combined to predict TIC occurrence was 0.900,the sensitivity was 0.923,and the specificity was 0.753.Conclusion TNF-α,HMGB1,and hs-CRP are factors affecting the occurrence of TIC in patients,and can be used as serum biomarkers for early screening of TIC.

关 键 词：肿瘤坏死因子-Α 高速泳动族蛋白B1 超敏C反应蛋白 急性创伤 创伤性凝血病 

分 类 号：R641[医药卫生—外科学]