目的 探讨瘦素蛋白(Leptin)在胸部创伤合并肺挫伤后患者血清中水平的动态变化特点及其临床意义.方法 选取40例胸部创伤合并肺挫伤患者,按照创伤严重度评分(ISS)标准划分为A组(<16分)共20例、B组(≥16分)20例.收集伤后1 h、第1、3、5、7、9、11、13天血清,另选取20例健康体检者为正常对照(C组)血清,采用竞争性放射免疫分析法检测血清Leptin水平.结果 与C组相比较,A组患者伤后血清Leptin水平表达逐渐上升,至伤后第3天达到高峰(P<0.05),随后下降至正常水平;B组血清中Leptin水平伤后第1天降至最低水平(P<0.05),随后逐渐上升至第7 天达最高水平(P<0.05);A、B两组峰值的均值差异无统计学意义;A组平均表达水平显著高于C组(P<0.05).结论 血清Leptin在轻度胸部创伤合并肺挫伤后呈升高趋势,而重度胸部创伤患者早期则呈先下降后升高趋势,提示血清Leptin可能在肺挫伤应激及修复阶段起重要作用.%Objective To invesligale the dynamic chanes of serum Leptin level and its clinical significance in the palienls with chest injuries combined with pulmonary constusion. Methods Forty chest injuries combined wilh pulmonary conslusion patients were divided into group A (ISS < 16) and group B (ISS ≥16) according to the ISS scores. And 20 heallhy people were used as control (group C). The radioimmunoassay was performed lo deled the serum Leplin level on 1 h, ld,3d,5d,7d,9d, 11 d and 13 d after the injury. Results Compared with group C, the Leptin mean concentration (LMC) of group A significantly increased and reached the peak value 3 d after injuried (P < 0.05) , and the LMC gradually relurned lo the normal control levels during the next 4 d. The LMC of group B sharply decreased to the lowest level 1 d, then gradually increased to the peak value during the coming 6 days after the injury. The LMC of group A were significantly higher than group B during 1 d and 3 d after trauma (P < 0.05). Conclusion The serum Leplin was significantly increased after slightly chest injuries combined with pulmonary conslusion palienls, and inversely it decreased in the initial stage of severe injury, indicating that Leptin played imporlanl roles in both wound stringency and repair.
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