摘要
目的探讨严重多发伤后血清胆碱酯酶（ChE）活性动态变化的意义及影响因素。方法用DTNB显色分光光度比色法检测53例患者伤后第1，3，7天的血清ChE、白蛋白（ALB）、血细胞比容（HCT）、前白蛋白（PAB）、转铁蛋白（TRF）、C反应蛋白（CRP）。记录ISS及急性生理和慢性健康评估Ⅲ（APACHEⅢ）评分，并进行统计学分析。结果伤后血清ChE活性均低于对照组且持续下降，与APACHEⅢ及ISS呈负相关。血清ChE活性在ISS≤25分组先下降后恢复，ISS〉25分组持续下降，在死亡和生存组均持续下降。伤后第1天与血清ChE变化显著相关的是HCT、PAB、TRF，第3天与TRF、ALB、CRP相关，第7天与PAB、CRP、ISS、TRF相关。结论血清ChE活性的动态变化有助于监测多发伤伤情，肝脏合成、血液稀释、炎症反应可不同程度影响其动态变化。
Objective To investigate the relationship between the dynamic change of serum cholinesterase （ChE） activity and severity, prognosis of patients with severe multiple injury and explore possible influencing factors. Methods Levels of serum ChE, albumin （ ALB）, haematocrit （HCT）, prealbumin （PAB）, transferrin （TRF）, C-reactive protein （CRP） of 53 patients with multiple trauma were detected at days 1,3 and 7 DTNB coloration spectroluminocity chromometry. At the same time, level of serum ChE of 55 patients （control group） was also detected. Injury severity was evaluated by acute physiology and chronic health evaluation Ⅲ （APACHEⅢ） score and injury severity score （ISS）. The data were analyzed statistically. Results The levels of serum ChE of patients with multiple trauma was lower than that of control group, decreased continuously and negatively correlated with APACHEⅢ and ISS. The level of serum ChE showed a rapid resume after a decrease in patients with ISS ≤25 points but continuously decreased in those with ISS 〉 25 points and in death and survival groups. The indices correlated significantly with change of serum ChE were HCT, PAB and TRF at day 1 post trauma, and TRF, ALB and CRP at day 3 post trauma and PAB, CRP, ISS and TRF at day 7 post trauma. Conclusions Dynamic change of serum ChE may be useful for monitoring injury severity. In the meantime, complex function of liver, bemedilution and inflammatory reaction can influence serum ChE activity at different degrees.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2008年第2期96-99,共4页
Chinese Journal of Trauma
关键词
多处创伤
血清胆碱酯酶
预后
Multiple trauma
Serum cholinesterase
Prognosis
