凝血功能及血清C反应蛋白、Tau蛋白水平对颅脑损伤程度和预后评价的意义

doi:10.3969/j.issn.1673-8640.2020.12.010

摘要/Abstract

摘要：

目的探讨颅脑损伤患者凝血功能、血清C反应蛋白（CRP）、Tau蛋白变化与病情严重程度和预后的相关性。方法选取103例颅脑损伤患者作为研究对象,根据格拉斯哥昏迷指数（GCS）分为重型组（30例）、中型组（39例）和轻型组（34例）,根据格拉斯哥预后量表（GOS）评分分为预后良好组（68例）和预后不良组（35例）。检测所有研究对象凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fib）和D二聚体（DD）等凝血功能指标水平以及CRP和Tau蛋白水平。结果不同程度颅脑损伤患者治疗前凝血功能以及血清CRP、Tau蛋白水平的差异均有统计学意义（P<0.05）。颅脑损伤程度越严重,PT、APTT、TT、DD、CRP以及Tau蛋白等指标水平越高,Fib水平越低,差异均有统计学意义（P<0.05）;预后良好组患者治疗前和治疗后PT、APTT、TT、DD、CRP以及Tau蛋白水平均低于预后不良组,Fib水平均高于预后不良组,差异有统计学意义（P<0.05）。结论颅脑损伤患者凝血功能以及血清CRP、Tau蛋白水平明显异常,且与病情的严重程度以及预后有关,可作为疾病诊断和病情监测的指标。

关键词: 颅脑损伤, 凝血功能, C反应蛋白, Tau蛋白, 预后

Abstract:

Objective To investigate the correlations of coagulation function,serum C-reactive protein（CRP）and Tau protein in patients with brain injury with the severity and prognosis of brain injury. Methods Totally,103 patients with brain injury were enrolled,which were classified into heavy group（30 cases）,medium group（39 cases） and light group（34 cases）. According to Glasgow Coma Scale（GCS）scores,they were classified into good prognosis group（68 cases） and poor prognosis group（35 cases）. Prothrombin time（PT）,activated partial thrombin time（APTT）,thrombin time （TT）,fibrinogen（Fib）,D-dimer（DD）,CRP and Tau protein levels were determined. Results There were statistical significance for coagulation function,serum CRP and Tau protein in different degrees of brain injury before treatment（P<0.05）. As the degree of brain injury increasing,the levels of PT,APTT,TT,DD,CRP and Tau protein were increased,and the level of Fib was decreased（P<0.05）. Before and after treatment,the levels of PT,APTT,TT,DD,CRP and Tau protein in good prognosis group were lower than those in poor prognosis group,and the level of Fib was higher than that in poor prognosis group（P<0.05）. Conclusions The levels of coagulation function,serum CRP and Tau protein are abnormal in patients with brain injury,and the above indicators were related to the degree of disease and prognosis,which can be used for disease diagnosis and disease monitoring.

Key words: Brain injury, Coagulation function, C-reactive protein, Tau protein, Prognosis

中图分类号:

R446.1

班立芳, 徐媛, 孔庆飞, 岳保红. 凝血功能及血清C反应蛋白、Tau蛋白水平对颅脑损伤程度和预后评价的意义[J]. 检验医学, 2020, 35(12): 1248-1251.

BAN Lifang, XU Yuan, KONG Qingfei, YUE Baohong. Roles of coagulation function,serum C-reactive protein and Tau protein in evaluating the severity and prognosis of brain injury[J]. Laboratory Medicine, 2020, 35(12): 1248-1251.

图/表 2

参考文献 16

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组别	例数	PT/s	APTT/s	TT/s	Fib/（g/L）	DD/（mg/L）	CRP/（mg/L）	Tau蛋白/（ng/L）
轻型组	34	12.68±1.99	33.50±5.98	14.38±2.30	2.53±0.55	2.37±0.54	20.52±4.03	17.06±3.79
中型组	39	15.79±2.77^*	38.42±6.81^*	19.21±3.07^*	2.29±0.41^*	3.60±0.85^*	34.87±6.06^*	21.13±4.17^*
重型组	30	18.73±3.38^*#	47.19±7.72^*#	22.90±3.91^*#	2.01±0.31^*#	4.41±0.99^*#	54.07±8.79^*#	29.00±5.16^*#
F值		38.769	29.314	60.166	11.380	52.181	208.428	61.064
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	PT/s	APTT/s	TT/s	Fib/（g/L）	DD/（mg/L）	CRP/（mg/L）	Tau蛋白/（ng/L）
轻型组	34	12.68±1.99	33.50±5.98	14.38±2.30	2.53±0.55	2.37±0.54	20.52±4.03	17.06±3.79
中型组	39	15.79±2.77^*	38.42±6.81^*	19.21±3.07^*	2.29±0.41^*	3.60±0.85^*	34.87±6.06^*	21.13±4.17^*
重型组	30	18.73±3.38^*#	47.19±7.72^*#	22.90±3.91^*#	2.01±0.31^*#	4.41±0.99^*#	54.07±8.79^*#	29.00±5.16^*#
F值		38.769	29.314	60.166	11.380	52.181	208.428	61.064
P值		<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数		PT/s			APTT/s			TT/s
组别	例数		治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前		治疗后1个月
预后良好组	68		14.24±2.94	9.52±1.89		36.06±7.52	31.17±6.25		16.85±3.72		11.02±2.68
预后不良组	35		18.30±3.35	12.38±2.70		45.74±8.19	39.06±7.08		22.26±4.00		15.10±3.23
t值			6.336	6.260		5.999	5.798		6.816		6.817
P值			<0.001	<0.001		<0.001	<0.001		<0.001		<0.001
组别	Fib/（g/L）			DD/（mg/L）			CRP/（mg/L）			Tau蛋白/（ng/L）
组别	治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前		治疗后1个月
预后良好组	2.42±0.50	2.97±0.61		2.97±0.75	1.14±0.22		27.58±8.76	4.18±0.74		19.15±4.45		7.35±1.67
预后不良组	2.03±0.32	3.86±0.80		4.33±0.95	1.93±0.51		51.55±10.68	9.53±1.86		27.77±5.91		12.03±2.36
t值	4.254	6.292		7.946	10.978		12.189	20.806		8.296		11.656
P值	<0.001	<0.001		<0.001	<0.001		<0.001	<0.001		<0.001		<0.001

组别	例数		PT/s			APTT/s			TT/s
组别	例数		治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前		治疗后1个月
预后良好组	68		14.24±2.94	9.52±1.89		36.06±7.52	31.17±6.25		16.85±3.72		11.02±2.68
预后不良组	35		18.30±3.35	12.38±2.70		45.74±8.19	39.06±7.08		22.26±4.00		15.10±3.23
t值			6.336	6.260		5.999	5.798		6.816		6.817
P值			<0.001	<0.001		<0.001	<0.001		<0.001		<0.001
组别	Fib/（g/L）			DD/（mg/L）			CRP/（mg/L）			Tau蛋白/（ng/L）
组别	治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前	治疗后1个月		治疗前		治疗后1个月
预后良好组	2.42±0.50	2.97±0.61		2.97±0.75	1.14±0.22		27.58±8.76	4.18±0.74		19.15±4.45		7.35±1.67
预后不良组	2.03±0.32	3.86±0.80		4.33±0.95	1.93±0.51		51.55±10.68	9.53±1.86		27.77±5.91		12.03±2.36
t值	4.254	6.292		7.946	10.978		12.189	20.806		8.296		11.656
P值	<0.001	<0.001		<0.001	<0.001		<0.001	<0.001		<0.001		<0.001