严重创伤患者大量输血前后凝血功能、血清IL-6、IL-10、sIL-2R水平变化及相关性  

Changes and Significance of Coagulation Function,Serum IL-6,IL-10 and SIL-2R Levels Before and After Massive Blood Transfusion in Patients with Severe Trauma

作　　者：朱瑞 刘欢 Zhu Rui;Liu Huan(Second Affiliated Hospital of Luohe Medical College,Luohe,Henan,462300,China)

机构地区：[1]河南省漯河市医学高等专科学校第二附属医院,河南漯河462300

出　　处：《黑龙江医学》2025年第8期961-963,967,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨严重创伤患者大量输血前后凝血功能、血清白细胞介素-6(IL-6)、IL-10、可溶性白介素-2受体(sIL-2R)水平变化及意义。方法:选取2022年10月—2023年9月河南省漯河市医学高等专科学校第二附属医院收治的50例严重创伤患者作为研究对象,对比患者大量输血前后凝血功能指标、血清IL-6、IL-10及sIL-2R水平变化情况,并分析以上指标与大量输血的相关性。结果:输血前后患者凝血功能指标有一定变化,其中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间(TT)输血后均长于输血前,而输血后不同时间对比,其中输血3 d后以上指标更长,纤维蛋白原(FIB)及血小板计数(PLT)水平输血后均低于输血前,而输血后不同时间对比,其中输血3 d后以上指标更低,差异均有统计学意义(F=159.983、184.764、150.693、136.547、1209.002,P<0.001);患者输血前后钾离子及钠离子变化显著,输血1 d及3 d后,钾离子水平高于输血前,且输血3 d后钾离子水平高于输血1 d后,钠离子低于输血前,且输血3 d后钠离子水平低于输血1 d后,差异均有统计学意义(F=11.252、200.733,P<0.001);患者输血前后血清IL-6、IL-10及s IL-2R水平变化显著,输血1 d及3 d后,钾离子水平高于输血前,且输血1 d后以上指标高于输血3 d后,差异均有统计学意义(F=969.690、297.761、224.263,P<0.001);Pearson线性分析可知,严重创伤患者大量输血与PT、APTT TT、IL-6、IL-10及sIL-2R呈正相关(r=0.423、0.523、0.417、0.423、0.323、0.412,P<0.001),与FIB及PLT呈负相关(r=-0.378、-0.223,P<0.05)。结论:大量输血可帮助严重创伤患者尽快恢复其血容量,但其凝血功能指标及血清IL-6、IL-10、sIL-2R水平会出现一定变化,因此大量输血时医护人员要对以上指标进行动态监测,以防出现凝血功能障碍及免疫抑制,威胁生命安全。Objective:To explore the changes and significance of coagulation function,serum interleukin-6(IL-6),IL-10 and soluble interleukin-2 receptor(sIL-2R)in patients with severe trauma before and after massive blood transfusion.Methods:50 patients with severe trauma in the hospital from October 2022 to September 2023 were selected as the research subjects.The changes of coagulation function indexes,serum IL-6,IL-10 and sIL-2R levels before and after massive blood transfusion were compared,and the correlation between the above indexes and massive blood transfusion was analyzed.Results:There were some changes in coagulation function indexes of patients before and after blood transfusion,among which PT,APTT and TT were longer after blood transfusion,and compared at different time after blood transfusion,the above indexes were longer,and the levels of FIB and PLT were lower after blood transfusion,while compared at different time after blood transfusion,the above indexes were lower,with statistically significant difference(F=159.983,184.764,150.693,136.547,1209.002;P<0.001).The changes of potassium ion and sodium ion in patients before and after blood transfusion were significant.After 1 and 3 days of blood transfusion,the potassium ion level was higher than that before blood transfusion.3 days after blood transfusion,the potassium ion level was longer than that after 1 day of blood transfusion.The sodium ion level was lower than that before blood transfusion,and the difference was statistically significant(F=11.252,200.733;P<0.001).The serum levels of IL-6,IL-10 and sIL-2R changed significantly before and after blood transfusion.1 day and 3 days after blood transfusion,the potassium ion level was higher than that before blood transfusion,and the above indexes were higher after 1 day of blood transfusion than after 3 days of blood transfusion,with statistically significant difference(F=969.690,297.761,224.263;P<0.001).Pearson linear analysis showed that massive blood transfusion was positively correlated with PT,APTT TT,IL

关 键 词：严重创伤 大量输血 凝血功能 血清白细胞介素-6 

分 类 号：R331.1[医药卫生—人体生理学]