多发性颅脑损伤患者不同时间TAT动态变化与脑损伤程度和预后的关系  

Dynamic changes of TAT in patients with multiple brain injury at different times and its relationship with the degree of brain injury and prognosis

作　　者：蔡昌呈 陈星宇 何济民 向城卫 刘应刚 CAI Changcheng;CHEN Xingyu;HE Jimin;XIANG Chengwei;LIU Yinggang(Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院,四川遂宁629000

出　　处：《中国实用神经疾病杂志》2024年第11期1387-1390,共4页Chinese Journal of Practical Nervous Diseases

基　　金：四川省医学会医学科研青年创新课题(编号:Q21028)。

摘　　要：目的探讨多发性颅脑损伤患者不同时间凝血酶-抗凝血酶复合物(TAT)的动态变化及与脑损伤程度和预后的关系。方法收集2019-01—2021-08遂宁市中心医院治疗的184例多发性颅脑损伤患者的临床资料。根据患者脑损伤程度分为轻型组(n=48)、中型组(n=64)、重型组(n=72),比较不同时间点TAT的动态变化,并分析其与脑损伤程度和预后的关系。结果3组患者不同时间点TAT水平组内比较,从高到低依次为伤后6 h内、第1天、第3天、第7天。3组不同时间点TAT水平组间比较,从高到低依次为重型组、中型组、轻型组,差异均有统计学意义(P<0.05)。随访12个月后,预后情况为恢复良好者24例,轻度残疾者52例,重度残疾者49例,植物生存者29例,死亡11例,不同程度患者的预后比较均有统计学差异(P<0.05)。多因素Cox回归分析显示,不同时间点TAT水平均为患者预后的独立预测因子(P<0.05)。结论不同时间点TAT变化与多发性颅脑损伤患者的脑损伤程度有关,不同时间点TAT水平可能作为颅脑损伤患者预后的独立预测因子。Objective To investigate the dynamic changes of thrombin antithrombin complex(TAT)in patients with multiple brain injury at different times and its relationships with the degree of brain injury and prognosis.Methods The clinical data of 184 patients with multiple brain injury who were treated in the Suining Central Hospital from January 2019 to August 2021 were collected in this study.The patients were divided into light group(n=48),medium group(n=64)and severe group(n=72)according to the degree of brain injury.The dynamic changes of TAT at different times were compared,and the relationship between the dynamic changes of TAT at different times and the degree of brain injury and prognosis was analyzed.Results The average level of TAT in the three groups at different times was from high to low on the 6-hour,the first day,the third day,and the seventh day.The average level of TAT in the three groups at different times was from high to low in the severe group,the medium group,and the light group,with statistical significance(P<0.05).After 12 months of follow-up,the prognosis was good in 24 cases,mild disability in 52 cases,severe disability in 49 cases,plant survivors in 29 cases,and death in 11 cases.There was a significant difference in the prognosis among different severity levels(P<0.05).Multivariate Cox regression analysis showed that TAT level at different times was an independent predictor of the prognosis of patients(P<0.05).Conclusion The change of TAT at different time is related to the degree of brain injury in patients with multiple brain injury.The levels of TAT at different times may be independent predictors of patients with brain injury.

关 键 词：多发性颅脑损伤 凝血酶-抗凝血酶复合物 凝血功能 预后 预测因子 

分 类 号：R651.15[医药卫生—外科学]