| 王文召,李娜,刘一鸣.颅脑损伤病儿纤维蛋白原 /白蛋白比值与进展性出血性损伤的相关性分析[J].安徽医药,2024,28(2):266-270. |
| 颅脑损伤病儿纤维蛋白原 /白蛋白比值与进展性出血性损伤的相关性分析 |
| Correlation analysis between fibrinogen/albumin ratio and progressive hemorrhagic injury in children with craniocerebral injury |
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| DOI：10.3969/j.issn.1009-6469.2024.02.012 |
| 中文关键词: 颅脑损伤 进展性出血性损伤 纤维蛋白原 白蛋白 |
| 英文关键词: Craniocerebral injury Progressive hemorrhagic injury Fibrinogen Albumin |
| 基金项目:南京医科大学科技发展基金项目( NMUB2018095) |
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| 中文摘要: |
| 目的 分析颅脑损伤病儿纤维蛋白原 /白蛋白比值( FAR)与进展性出血性损伤( PHI)的相关性。方法选取 2019年 3月至 2021年 6月南京医科大学附属儿童医院收治的颅脑创伤病儿 130例，根据第二次 CT检查结果(入院后 24 h内)将病儿分为 PHI组( 32例)和无进展组( 98例)，收集病儿一般资料；采用凝固法检测血浆纤维蛋白原( Fib)水平，免疫比浊法检测血浆白蛋白( Alb)水平，并计算 FAR；采用 ROC曲线分析 FAR对颅脑损伤病儿发生 PHI的预测价值；采用多因素 logistic回归分析影响颅脑损伤病儿发生 PHI的危险因素。结果 PHI组入院时格拉斯哥昏迷量表( GCS)评分、颅脑创伤类型、赫尔辛基 CT评分［( 4.70±1.38)分比( 2.55±0.72)分］、受伤时间［( 1.39±0.42)h比( 2.01±0.63)h］、受伤到首次复查 CT时间［(3.75±1.04)h比( 8.12±2.59)h］、入院时血小板计数［(175.33±56.29)×109/L比(201.45±62.07)×109/L］入院时 D-二聚体［( 7.28±2.32)mg/L比( 3.09±1.01) mg/L］及癫痫、头痛和呕吐、瞳孔散大比例与无进展组比较，均差异有统计义( P<0.05)。 PHI组病儿血浆 Fib水平［( 3.41± 学意、0.52)g/L比( 3.74±0.63)g/L］及 Alb水平［( 33.25±5.27)g/L比( 41.97±6.58)g/L］均低于无进展组(均 P<0.05)FAR高于无进展组(0.103±0.012比 0.089±0.009，P<0.05)。 FAR预测 PHI的曲线下面积为 0.89，明显高于血浆 Fib水平(Z=3.96<0.001)、血浆 Alb水平( Z=1.66，P=0.048)。受伤到首次复查 CT时间、入院时 D-二聚体、血浆 Fib、Alb水平及 FAR均是影响颅脑损伤病儿发生 PHI的独立危险因素(均 P<0.05)。结论 FAR升高与颅脑损伤病儿发生 PHI有关，可作为预测颅脑损伤病儿发生 PHI的依据。，P， |
| 英文摘要: |
| Objective To analyze the correlation between fibrinogen/albumin ratio (FAR) and progressive hemorrhagic injury (PHI)in children with brain injury.Methods A total of 130 children with craniocerebral injury in this hospital were selected. According tothe results of the second CT examination (within 24 hours after admission), the children were divided into PHI group (32 cases) and noprogression group (98 cases). Collect general information of children. Coagulation method was used to detect plasma fibrinogen (Fib)level,immunoturbidimetric method was used to detect plasma albumin (Alb) level, and calculate FAR;ROC curve was used to analyzethe predictive value of FAR for PHI in children with craniocerebral injury; multivariate logistic regression analysis was used to analyzethe risk factors of PHI in children with craniocerebral injury.Results There were significant differences in glasgow coma scale (GCS)scores at admission, types of craniocerebral injury,Helsinki CT Score[(4.70±1.38) points vs. (2.55±0.72) points], injury time[(1.39±0.42) h vs. (2.01±0.63)h], time from injury to the first reexamination of CT[(3.75±1.04)h vs. (8.12±2.59)h], platelet count at admission [(175.33±56.29)×109/L vs. (201.45±62.07)×109/L], D-dimer[(7.28±2.32)mg/L vs. (3.09±1.01)mg/L] and the proportion of epilepsy, head. ache and vomiting, and mydriasis between the PHI group and the progression-free group (all P<0.05).The plasma Fib[(3.41±0.52)g/L vs. (3.74±0.63) g/L] and Alb levels[(33.25±5.27)g/L vs. (41.97±6.58)g/L] of children in the PHI group were lower than those in the progres. sion-free group (all P<0.05), and the FAR was higher than that in the progression-free group(0.103±0.012 vs. 0.089±0.009, P<0.05).The area under the curve of PHI predicted by FAR was 0.89, which was significantly higher than the single prediction of the plasma Fiblevel (Z=3.96, P<0.001) and the plasma Alb level (Z=1.66, P=0.048). The time from injury to the first reexamination of CT, D-dimer, plasma Fib and Alb levels and FAR were independent risk factors for PHI in children with craniocerebral injury (all P<0.05).Conclu. sion The increase in FAR is related to the occurrence of PHI in children with craniocerebral injury, and can be used as a basis forpredicting the occurrence of PHI in children with craniocerebral injury. |
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