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目的 :研究多发伤病人血清新喋呤的变化 ,并探讨其与创伤严重度、感染及脏器功能不全的关系。方法 :测定 2 8例多发伤病人伤后第 1天、第 3天、第 8天血清新喋呤水平 ,同时评定ISS值、APACHEⅡ评分及记录血常规、感染、脏器功能不全情况。结果 :多发伤病人血清新喋呤为 8 81± 7 5 6ng/ml,显著高于对照组的 1 37± 0 75ng/ml (P <0 0 1) ;新喋呤水平与APACHEⅡ评分值正相关 (r =0 5 8,P =0 0 2 ) ;发生脏器功能不全组新喋呤及APACHEⅡ值高于脏器功能正常组 ;发生感染后血清新喋呤从 5 0 5± 4 13ng/ml升至 11 0 3± 10 42ng/ml (P <0 0 5 )。结论 :创伤可引起血清新喋呤水平的升高 ,且与创伤严重度正相关 ;监测血清新喋呤水平变化有助于及早发现感染 ,并可预警MODS的发生
Objective: To study the changes of serum neopterin in patients with multiple traumatic injuries and to explore its relationship with the severity of trauma, infection and organ dysfunction. Methods: Serum neopterin level was measured on the first day, the third day and the eighth day after the trauma in 28 cases. The ISS, APACHEⅡscore and blood routine, infection and organ dysfunction were also evaluated. Results: Serum neopterin in patients with multiple trauma was 8 81 ± 7 5 6 ng / ml, which was significantly higher than that of the control group (37 ± 0 75 ng / ml, P 0 01). Neopterin level was positively correlated with APACHE Ⅱ score (R = 0 58, P = 0 0 2). The levels of neopterin and APACHEⅡ in patients with organ dysfunction were higher than those in normal organs. The serum neopterin level after infection was increased from 5 0 5 ± 4 13ng / ml to 11 0 ± 10 42 ng / ml (P <0 05). CONCLUSIONS: Trauma can cause an increase in serum neopterin and is positively correlated with the severity of trauma. Monitoring changes in serum neopterin may be helpful in early detection of infection and early detection of MODS