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目的探讨颅脑损伤急性期血小板(PLT)参数与外伤性脑梗死(TCI)的关系。方法选取2010年9月-2012年1月符合纳入除标准的颅脑损伤患者191例。将伤后14 d内发生脑梗死的患者划入观察组,余为对照组。分别于伤后第24、48小时,第3、7、14天,采集肘静脉血对PLT计数、PLT平均体积(MPV)、PLT体积分布宽度(PDW);伤后24 h行格拉斯哥昏迷评分(GCS),伤后6个月随访行格拉斯哥结果评分(GOS)。分别分析脑梗死与上述PLT参数的关系、PLT参数与颅脑损伤病情轻重的关系以及与预后的关系。结果观察组PLT计数降低、MPV升高、PDW升高;观察组患者GCS/GOS与PLT计数呈正相关,与MPV、PDW呈负相关。结论 PLT计数、MPV、PDW均与TCI有关,三者中PLT最具临床意义。PLT计数越低、MPV和PDW越高,脑梗死可能性越大,颅脑损伤可能越严重,预后可能越差。
Objective To investigate the relationship between platelet (PLT) parameters and traumatic cerebral infarction (TCI) in the acute stage of brain injury. Methods Totally 191 patients with craniocerebral injury who met the criteria from September 2010 to January 2012 were enrolled. The patients with cerebral infarction within 14 days after injury were assigned to the observation group, the rest for the control group. The PLT, MPV and PDW were measured at the 24th, 48th hour and the 3rd, 7th and 14th day after injury respectively. The Glasgow Coma Scale GCS), Glasgow outcome score (GOS) was followed up 6 months after injury. The relationship between cerebral infarction and PLT parameters mentioned above, the relationship between PLT parameters and severity of head injury and its relationship with prognosis were analyzed. Results In observation group, PLT count decreased, MPV increased, and PDW increased. GCS / GOS was positively correlated with PLT count and negatively correlated with MPV and PDW in observation group. Conclusion PLT count, MPV and PDW are all related to TCI, and PLT has the most clinical significance. The lower the PLT count, the higher the MPV and PDW, the greater the probability of cerebral infarction, the more severe the brain injury and the poorer the prognosis.