和肽素和凝血功能监测在重型脑外伤病情评估和预后判断中的作用

摘要

目的:探讨和肽素和凝血功能监测在重型颅脑外伤病情严重程度和预后评估中的作用.方法:收集83例重型颅脑外伤患者的临床病历资料,将患者按照不同APACHEⅡ评分、死亡或存活、是否发生器官衰竭进行分组,分别比较不同组患者的和肽素水平和凝血功能相关指标.结果:并发多器官功能障碍综合征(MODS)者其血小板(PLT)明显低于未并发MODS者,而纤维蛋白原降解产物(FDP)、D-二聚体(D-dimer)明显高于未并发MODS者,同时其凝血酶时间(PT)、活化部分凝血酶原时间(APTT)明显延长,和肽素水平明显高于未发生MODS组;死亡组患者与存活组患者相比,其PLT明显下降,D-dimer明显增高,同时PT、APTT明显延长,和肽素水平也明显增加;且和肽素水平、PLT、PT、APTT异常患者的APACHEⅡ评分明显高于正常组(P<0.05). 结论:和肽素和凝血功能监测可以帮助评估重型脑外伤患者的病情严重程度和预后.%Objective:To explore the role of copeptin and coagulation function monitoring in evaluating disease conditions and prognosis of patients with severe brain injury.Methods:We collected the clinical and laboratory data of 83 patients with severe brain injury.The patients were grouped in terms of APACHE Ⅱ score, survival and dead, or MODS.The levels of copeptin and coagulation function were compared in those different groups.Results:The number of PLT in the MODS group was notably less than in the non-MODS group.The levels of FDP, D-dimer, PT, APTT and copeptin in the MODS group were significantly higher than in the non-MODS group.There were also significant differences in those levels between survival group and dead group, and different APACHE Ⅱ score groups (P<0.05).Conclusion:The copeptin and coagulation function related indicators can help to assess the severity and the prognosis of patients with severe brain injury.