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目的探讨急性颅脑损伤患者外周血中C反应蛋白(CRP)和白细胞(WBC)计数动态变化与颅脑损伤程度及预后的关系。方法测定206例急性颅脑损伤患者在3 h、24 h、2~30 d(或出院时)外周血中CRP和WBC计数,根据格拉斯哥昏迷评分法(GCS)分型和格拉斯哥预后评分法(GOS)分级,分析CRP、WBC计数与不同类型颅脑损伤患者病情演变及预后的关系。结果 CRP水平与GCS评分呈负相关(r=-0.582,P<0.05),轻、中、重型颅脑损伤组患者外周血中CRP在伤后3 h均开始升高,第4天达高峰,轻型颅脑损伤组在第5天开始回落,第7天恢复正常,中型颅脑损伤组在第14天基本恢复正常,重型颅脑损伤组第30天仍然高于正常。WBC计数与GCS评分呈负相关(r=-0.267,P<0.05),轻、中、重型颅脑损伤组患者伤后3 h外周血中WBC计数均开始升高,24 h达到高峰,随后渐回落,第7天及出院时恢复正常。CRP水平与GOS评分呈负相关(r=-0.267,P<0.05),WBC计数与GOS评分呈负相关(r=-0.392,P<0.05)。结论外周血CRP和WBC计数可作为判断急性颅脑损伤程度及预后的重要监测指标。
Objective To investigate the relationship between dynamic changes of C-reactive protein (CRP) and white blood cell (WBC) counts in peripheral blood and brain injury severity and prognosis in patients with acute craniocerebral injury. Methods The CRP and WBC count in peripheral blood of 206 patients with acute craniocerebral injury at 3 h, 24 h, 2 ~ 30 d (or at discharge) were determined. According to Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) ) Were graded to analyze the relationship between CRP and WBC counts and the progression and prognosis of patients with different types of craniocerebral injury. Results CRP level was negatively correlated with GCS score (r = -0.582, P <0.05). The levels of CRP in peripheral blood of patients with mild, moderate and severe traumatic brain injury increased at 3 h and peaked at 4 d, The group of mild craniocerebral injury started to fall back on the fifth day and returned to normal on the seventh day. The group of medium-sized craniocerebral injury returned to normal on the 14th day, while the group of severe craniocerebral injury was still higher than the normal on the 30th day. WBC count was negatively correlated with GCS score (r = -0.267, P <0.05). WBC counts in peripheral blood of mild, moderate and severe traumatic brain injury group began to increase at 3 h and peaked at 24 h Down, on the 7th day and returned to normal at discharge. The level of CRP was negatively correlated with GOS score (r = -0.267, P <0.05). WBC count was negatively correlated with GOS score (r = -0.392, P <0.05). Conclusion Peripheral blood CRP and WBC count can be used as an important monitoring index to judge the degree and prognosis of acute brain injury.