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目的:探讨肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、血小板活化因子(PAF)与重症胸腹损伤后凝血功能障碍的相关性。方法:112例重症胸腹损伤患者的创伤指数(TI)≥17分,检测血小板(PLT)、血浆D-二聚体(D-D)、部分活化凝血酶原时间(APPT)、TNF-α、LPS、PAF,对检验结果进行相关性分析。结果:PLT:(73.14±32.59)×109/L,D-D:(1 893.87±508.72)U/L,APTT:(78.29±14.52)s。TNF-α:(39.61±13.09)ng/ml,LPS:(453.68±96.37)IU/L,PAF:(15 969.31±4 031.65)ng/L。PLT与TNF-α、LPS、PAF之间相关系数r均<-0.8951,显著负相关。D-D、APTT与TNF-α、LPS、PAF之间r均>0.9307,显著正相关。结论:TNF-α、LPS、PAF可能参与了胸腹创伤后凝血功能障碍的发生,早期干预可能改善重症胸腹创伤患者的凝血功能障碍。
Objective: To investigate the correlation between tumor necrosis factor-α (TNF-α), endotoxin (LPS), platelet-activating factor (PAF) and coagulation dysfunction after severe thoracoabdominal injury. Methods: The traumatic index (TI) of 112 patients with severe thorax and abdomen injury was ≥17. The platelet count (PLT), plasma D-dimer (DD), partial activated prothrombin time (APPT), TNF- , PAF, correlation analysis of test results. Results: PLT: (73.14 ± 32.59) × 109 / L, D-D: (1 893.87 ± 508.72) U / L and APTT: (78.29 ± 14.52) s. TNF-α: (39.61 ± 13.09) ng / ml, LPS: (453.68 ± 96.37) IU / L and PAF: (15 969.31 ± 4 031.65) ng / L. The correlation coefficient r between PLT and TNF-α, LPS and PAF were all <-0.8951, significant negative correlation. There was a significant positive correlation between D-D, APTT and TNF-α, LPS and PAF (r> 0.9307). CONCLUSION: TNF-α, LPS and PAF may be involved in the development of coagulation dysfunction after thoraco-abdominal trauma. Early intervention may improve coagulation dysfunction in patients with severe thoracoabdominal trauma.