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目的探讨不同病情的成年颅脑损伤昏迷患者血清褪黑素水平变化的临床意义。方法选择61例成年颅脑损伤且昏迷患者,根据入院时GCS评分分为特重型、重型及中型三组进行研究。同时选择31例成年健康志愿者作为对照组。颅脑损伤组分别在入院后第1、37、日早晨6:00,下午16:00采集2次血标本并测定其MT水平。根据不同转归,在出院时及出院后3个月,分别对颅脑损伤组各组间及其与对照组之间进行比较。结果至出院,全组存活48例,死亡13例,死亡病例死亡前平均血清褪黑素水平为19.1±9.8pg/ml。各颅脑损伤组血清MT水平在损伤后各时间点均显著低于对照组(P<0.05),各时间点重型组和特重型组的MT水平显著低于中型组(P<0.05),特重型组的MT水平又显著低于重型组(P<0.05)。结论颅脑损伤患者血清MT水平越低,颅脑损伤的病情越重,GOS预后评分越低,患者的伤残程度越重。
Objective To investigate the clinical significance of serum melatonin level in adult patients with craniocerebral injury and coma with different diseases. Methods Sixty-one adult patients with traumatic brain injury and coma were enrolled in this study. The patients were divided into three groups according to their GCS score: super heavy, heavy and medium. At the same time, 31 healthy adult volunteers were selected as the control group. Traumatic brain injury group were collected on the 1st, 3rd, 7th, 6th day morning and 16:00 afternoon after admission. Blood samples were collected twice and their MT levels were measured. According to different outcomes, at the time of discharge and 3 months after discharge, we compared the groups of craniocerebral injury and those of the control group respectively. Results After discharge, all patients survived in 48 cases and died of 13 cases. The mean serum melatonin level before death was 19.1 ± 9.8pg / ml. The serum levels of MT in each brain injury group were significantly lower than those in the control group at each time point (P <0.05). The MT levels of the severe and severe TB patients at each time point were significantly lower than those in the middle group (P <0.05) The MT level in the severe group was significantly lower than that in the severe group (P <0.05). Conclusions The lower serum MT level in patients with craniocerebral injury, the heavier the severity of craniocerebral injury, the lower the GOS prognosis score, the more severe the disability of patients.