急性颅脑损伤血清P—选择素监测的临床价值(1)
【摘要】 目的：探讨血清P-选择素(P-selectin)在急性颅脑损伤监测中的临床价值。方法：90例急性颅脑损伤患者根据GCS评分分为轻型组(30例)、中型组(30例)和重型组(30例)，检测三组发病后第1天血清P-selectin及D-Dimer表达水平。同时选择30例门诊健康体检者作为对照组，检测对照组及急性颅脑损伤患者发病后第1、3及7天时血清P-selectin及D-Dimer表达水平。结果：各组急性颅脑损伤患者血清P-selectin及D-Dimer表达水平均明显高于对照组，且随着临床分型逐渐加重，血清P-selectin及D-Dimer表达水平明显升高；急性颅脑损伤患者发病后第1、3及7天血清P-selectin及D-Dimer表达水平均明显高于对照组，且随着发病日期逐渐延长，血清P-selectin及D-Dimer表达水平明显降低；血清P-selectin表达与D-Dimer表达呈正相关性关系，比较差异均具有统计学意义(P<0.05)。结论：血清P-选择素在急性颅脑损伤病情严重程度及转归评估方面均具有较高的临床价值。
, http://www.100md.com
【关键词】 急性颅脑损伤； P-选择素； D-二聚体
【Abstract】 Objective：To investigate the clinical value of serum P-selectin in monitor of patients with acute brain injury.Method：90 patients with acute brain injury were divided into light group (30 cases)，medium group (30 cases) and severe group (30 cases) according to GCS scores.The expression levels of serum P-selectin and D-Dimer 1 d after onset in the three groups were detected.While 30 healthy outpatients were selected as control group，the expression levels of serum P-selectin and D-Dimer 1，3，and 7 d after onset in the control group and patients with acute brain injury were detected.Result：The expression levels of serum P-selectin and D-Dimer of patients with acute brain injury were significantly higher than that of the control group (P<0.05)，and with the clinical classification gradually increased，the expression levels of serum P-selectin and D-Dimer significantly increased (P<0.05).The expression levels of serum P-selectin and D-Dimer in patients with acute brain injury 1，3 and 7 d after onset were significantly higher that of the control group (P<0.05)，and with the gradual onset date prolonged，the expression levels of serum P-selectin and D-Dimer were significantly lower (P<0.05).The expression of serum P-selectin had a positively correlated with the expression of D-Dimer (P<0.05).Conclusion：Serum P-selectin has a high clinical value in assess of severity and outcome aspects of patients with acute brain injury.
, 百拇医药
【Key words】 Acute brain injury； P-selectin； D-dimer
急性颅脑组织损伤可激活活化机体内的凝血系统造成异常的高凝病理状态，而此种状态及其所致的纤溶功能亢进均可加重脑组织的损害严重程度，最终对患者预后情况造成严重影响[1-4]。P-选择素(P-selectin)是黏附分子选择素家族中的一个重要成员，其主要表达在已激活活化的血小板和血管内皮细胞表面，通过介导细胞最初的黏附启动过程而在白细胞黏附、迁移等级联过程中发挥重要的生理学作用。P-selectin与机体免疫防御系统生理功能，以及大部分疾病之间均存在十分密切的相关性，尤其在炎症感染反应、血管内血栓形成、肿瘤细胞远处转移等病理生理过程中发挥着极为重要的作用。此外，P-selectin也是血小板激活活化及释放的特异性实验室指标，可在某种程度上反映血小板的黏附、聚集等生理学功能[5]。血浆D-二聚体(D-Dimer)是纤维蛋白单体由活化因子Ⅷ交联作用后，再经过纤溶酶水解作用而产生的特异性降解产物，其由D区α、β、γ段构成，易与E片段形成结构比较稳定的复合物，尤其在血浆中稳定性更好，且具有较高的敏感性和特异性，可作为反应机体内高凝病理状态和纤溶功能异常亢进的特异性实验室标志物，对高凝和血栓疾病的临床诊断、疗效评估和疾病预后判断等多方面均具有十分重要的临床价值。如果血清D-Dimer表达水平明显增高则提示体内存在着高凝病理状态或间接性提示体内有促高凝的因素存在，且已激活火化了凝血的内源或外源途径。D-Dimer则可反映高凝异常状态和继发性纤溶等[6]。因此本研究拟探讨血清P-selectin在监测急性颅脑损伤中的临床价值。, http://www.100md.com(彭昌海 彭俊云 叶建俊)
, http://www.100md.com
【关键词】 急性颅脑损伤； P-选择素； D-二聚体
【Abstract】 Objective：To investigate the clinical value of serum P-selectin in monitor of patients with acute brain injury.Method：90 patients with acute brain injury were divided into light group (30 cases)，medium group (30 cases) and severe group (30 cases) according to GCS scores.The expression levels of serum P-selectin and D-Dimer 1 d after onset in the three groups were detected.While 30 healthy outpatients were selected as control group，the expression levels of serum P-selectin and D-Dimer 1，3，and 7 d after onset in the control group and patients with acute brain injury were detected.Result：The expression levels of serum P-selectin and D-Dimer of patients with acute brain injury were significantly higher than that of the control group (P<0.05)，and with the clinical classification gradually increased，the expression levels of serum P-selectin and D-Dimer significantly increased (P<0.05).The expression levels of serum P-selectin and D-Dimer in patients with acute brain injury 1，3 and 7 d after onset were significantly higher that of the control group (P<0.05)，and with the gradual onset date prolonged，the expression levels of serum P-selectin and D-Dimer were significantly lower (P<0.05).The expression of serum P-selectin had a positively correlated with the expression of D-Dimer (P<0.05).Conclusion：Serum P-selectin has a high clinical value in assess of severity and outcome aspects of patients with acute brain injury.
, 百拇医药
【Key words】 Acute brain injury； P-selectin； D-dimer
急性颅脑组织损伤可激活活化机体内的凝血系统造成异常的高凝病理状态，而此种状态及其所致的纤溶功能亢进均可加重脑组织的损害严重程度，最终对患者预后情况造成严重影响[1-4]。P-选择素(P-selectin)是黏附分子选择素家族中的一个重要成员，其主要表达在已激活活化的血小板和血管内皮细胞表面，通过介导细胞最初的黏附启动过程而在白细胞黏附、迁移等级联过程中发挥重要的生理学作用。P-selectin与机体免疫防御系统生理功能，以及大部分疾病之间均存在十分密切的相关性，尤其在炎症感染反应、血管内血栓形成、肿瘤细胞远处转移等病理生理过程中发挥着极为重要的作用。此外，P-selectin也是血小板激活活化及释放的特异性实验室指标，可在某种程度上反映血小板的黏附、聚集等生理学功能[5]。血浆D-二聚体(D-Dimer)是纤维蛋白单体由活化因子Ⅷ交联作用后，再经过纤溶酶水解作用而产生的特异性降解产物，其由D区α、β、γ段构成，易与E片段形成结构比较稳定的复合物，尤其在血浆中稳定性更好，且具有较高的敏感性和特异性，可作为反应机体内高凝病理状态和纤溶功能异常亢进的特异性实验室标志物，对高凝和血栓疾病的临床诊断、疗效评估和疾病预后判断等多方面均具有十分重要的临床价值。如果血清D-Dimer表达水平明显增高则提示体内存在着高凝病理状态或间接性提示体内有促高凝的因素存在，且已激活火化了凝血的内源或外源途径。D-Dimer则可反映高凝异常状态和继发性纤溶等[6]。因此本研究拟探讨血清P-selectin在监测急性颅脑损伤中的临床价值。, http://www.100md.com(彭昌海 彭俊云 叶建俊)