朱芳张莉程含刘绍华(. 江西省萍乡矿业集团总医院检验科 江西 337000；. 江西省萍乡市妇幼保健院检验科 江西 337000 )

D-D、hs-CRP蛋白在颅内进展性出血性损伤患者血浆中的表达水平及其临床意义

朱芳1*张莉1程含1刘绍华2
(1. 江西省萍乡矿业集团总医院检验科 江西 337000；2. 江西省萍乡市妇幼保健院检验科 江西 337000 )

摘 要目的：探讨血浆中D-二聚体（D-dimer, D-D）、超敏C反应蛋白（high-sensitivity C-reaction protein, hs-CRP）在颅内进展性出血性损伤患者中表达及其临床意义。方法：选取2009年10月至2013年12月期间我院确诊治疗的颅脑损伤合并颅内进展性出血性损伤患者87例作为颅内损伤组，依据格拉斯哥昏迷评分（Glasgow Coma Scale, GCS）分为轻度、中度和重度亚组、格拉斯哥预后评分（Glasgow Outcome Scale, GOS）分为优秀、良好和不良亚组；同期选取体检健康人员10例作为健康组。应用免疫比浊法测定所有受试者血浆中D-D、hs-CRP水平，并对颅脑损伤组进行GCS和GOS评分，统计分析颅脑损伤患者血浆中D-D、hs-CRP水平与GCS、GOS和发病原因的关系。结果：颅脑损伤组患者血浆中D-D、hs-CRP水平明显高于健康组（P<0.05），且重度亚组高于中度和轻度亚组（P<0.05）、不良亚组高于良好和优秀亚组（P<0.05）；Spearman分析结果表明，D-D和hs-CRP水平均与GCS、GOS呈负相关。结论：血浆中D-D、hs-CRP水平可有效反映颅内进展性出血性损伤病情，早期检测有助于医师了解患者伤情和预后。

关键词D-二聚体 超敏C反应蛋白 出血性损伤

Expression of D-D, hs-CRP protein in the plasma of patients with intracranial progressive hemorrhagic injury and its clinical significance

ZHU Fang1*, ZHANG Li1, CHEN Han1, LIU Shaohua2
(1. Clinical Laboratory, The General Hospital of Jiangxi Pingxiang Mining Group, Jiangxi 337000, China; 2. Clinical Laboratory, Maternal and Child Health-Care Hospital of Pingxiang City, Jiangxi 337000, China)

ABSTRACTObjective: To investigate the expression of D-dimer (D-D) and high sensitive C reactive protein (hs-CRP)in the plasma of patients with intracranial progressive hemorrhagic injury and its clinical significance. Methods: Eightyseven patients diagnosed in our hospital from October, 2009 to December, 2013 were selected as an injury group, which was further divided into mild, moderate or severe subgroups based on Glasgow Coma Scale (GCS) score and excellent, good or poor subgroups based on Glasgow Outcome Scale (GOS) score. Meanwhile, 10 healthy persons were selected as a control group. D-D, hs-CRP levels in all subjects were measured by immune turbidimetry and both GCS and GOS scores were performed in the injure group. The relationship of D-D , hs-CRP levels and GCS, GOS with etiology were statistically analyzed. Results: D-D and hs-CRP levels were obviously higher in the injury group, severe subgroup and poor subgroup than in the healthy group, mild and moderate subgroups and good and excellent subgroups in turns, respectively (P<0.05).The analysis of Spearman showed that D-D and hs-CRP levels were all negatively correlated with GCS, GOS. Conclusion: D-D and hs-CRP level in plasma can effectively reflect the intracranial progressive hemorrhagic injury and early detection can help doctors understand the severity and prognosis of the patients.

KEY WORDSD-dimer; high sensitivity C-reaction protein; hemorrhagic lesions

颅脑外伤常见致病原因有运动性撞击、高空坠落、机动车碰撞等，主要临床表现为意识障碍、头痛、瞳孔

散大和血肿等症状，且易发生或并发各种出血性疾病，加重患者的伤情[1]。颅内进展性出血性损伤是指颅内各种出血性疾病经影像学或手术检查证实原发出血部位发生更严重的出血症状或并发新的出血部位，属于颅脑外伤最常见的并发症之一[2]。此外，颅内进展性出血性损伤可致使颅脑外伤患者缺血缺氧的发生，并进一步损害脑组织和神经组织，致使患者病情加剧恶化，增加患者伤残率和死亡率[3]。……