汶川地震伤患者不同时间段血浆纤维蛋白原的变化
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摘要
目的探讨地震伤患者不同时间段纤维蛋白原(Fbg)水平的变化,为临床治疗及预防血栓的形成提供实验室依据。方法将2 301例地震致伤患者按入院就诊时间分为5组,回顾性分析代表不同时间段的各组Fgb水平,并与相似气候条件下2 513例非地震伤患者组成的对照组作比较;观察27例下肢骨折患者入院24 h之内治疗前后Fbg的情况,分析患者应激状态下的Fbg变化。结果各组Fbg水平分布存在差异(P<0.05),病程前期的第1周和第2周患者较对照组明显升高(t_1=0.042,t_2=0.053,均P<0.05);病程后期Fbg水平逐渐恢复。27例下肢骨折患者经初步治疗后,24 h内88.9%的患者Fbg水平不同程度下降。结论地震伤可使Fbg水平一过性升高,Fbg是反映急性应激状态和凝血功能变化的一项敏感指标。
Objective To explore fibrinogen(Fbg) variety in different course of disease with patients suffered injury in the earthquake,and its role in the coagulation study.Methods 2 301 patients who suffered injury on the day of the earthquake were divided into 5 groups according to admission date.The Fbg values of these groups on behalf of different course of disease were compared with the control group which consisted of 2 513 non-seismic trauma patients under similar climatic conditions,retrospectively.Tracking Fbg variety of 27 fracture patients before and after treatment within 24 h,and evaluate the change trends.Results The Fbg distribution of different groups shows significant differences(P<0.05),especially in the first two weeks,which show elevated Fbg levels compared to the control group(t_1 = 0.042,t_2 = 0.053,P<0.05), and the gradual recovery of Fbg levels were seen in course of the late.88.9%of 27 fracture patients were observed declined Fbg after the initial treatment.Conclusion The earthquake injured would made Fbg levels transiently elevated,and Fbg is a sensitive target in reflecting the variety of acute stress and blood coagulation.
Objective To explore fibrinogen(Fbg) variety in different course of disease with patients suffered injury in the earthquake,and its role in the coagulation study.Methods 2 301 patients who suffered injury on the day of the earthquake were divided into 5 groups according to admission date.The Fbg values of these groups on behalf of different course of disease were compared with the control group which consisted of 2 513 non-seismic trauma patients under similar climatic conditions,retrospectively.Tracking Fbg variety of 27 fracture patients before and after treatment within 24 h,and evaluate the change trends.Results The Fbg distribution of different groups shows significant differences(P<0.05),especially in the first two weeks,which show elevated Fbg levels compared to the control group(t_1 = 0.042,t_2 = 0.053,P<0.05), and the gradual recovery of Fbg levels were seen in course of the late.88.9%of 27 fracture patients were observed declined Fbg after the initial treatment.Conclusion The earthquake injured would made Fbg levels transiently elevated,and Fbg is a sensitive target in reflecting the variety of acute stress and blood coagulation.
引文
[1]马西.纤维蛋白原与血栓形成[J].血栓与止血学,2001,7(3): 128-131.
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[3]VAYA A,MIRA Y,MARTINEZ M,et al.Activation of blood coagula-tion in pigs following lower limb gunshot trauma[J].Blood Coagul Fibrinolysis,2001,12:477-485.
[4]梁效功,王羽,吴华新.214例地震伤患者的血纤维蛋白分析[J].华西医学,2008,6(23):1328-1328.
[5]GEERTS WH,CODE KI,JAY RM,et al.A prospective study of venous Thromboembolism after major trauma[J].N Engl J Med,1994, 331(24):1601-1606.
[6]FLINTERMAN LE,VAN HYLCKAMA VLIEG A,ROSENDAAL FR,et al.Recurrent Thrombosis and Survival After a First Venous Thrombosis of the Upper Extremity[J].Circulation Sep,2008,118: 1366-1372.
[2]VANCE G N,JERROLD H L.Fibrinogen and Bleeding:Old Molecule-New Ideas[J].Anesth.Analg,2007,105(10):902-903.
[3]VAYA A,MIRA Y,MARTINEZ M,et al.Activation of blood coagula-tion in pigs following lower limb gunshot trauma[J].Blood Coagul Fibrinolysis,2001,12:477-485.
[4]梁效功,王羽,吴华新.214例地震伤患者的血纤维蛋白分析[J].华西医学,2008,6(23):1328-1328.
[5]GEERTS WH,CODE KI,JAY RM,et al.A prospective study of venous Thromboembolism after major trauma[J].N Engl J Med,1994, 331(24):1601-1606.
[6]FLINTERMAN LE,VAN HYLCKAMA VLIEG A,ROSENDAAL FR,et al.Recurrent Thrombosis and Survival After a First Venous Thrombosis of the Upper Extremity[J].Circulation Sep,2008,118: 1366-1372.
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