摘要
目的探讨重度脑创伤患者血浆游离肉碱水平的变化及其与预后的关系。方法选取2015年1月-2017年1月本院收治的80例重度脑创伤患者作为研究对象,选取同期体检的健康人群作为对照组(n=80),分别于患者受伤后12、24 h、2、3及5 d检测血浆游离肉碱水平。比较2组患者、不同预后患者的血浆游离肉碱水平,并分析血浆游离肉碱水平与预后的关系,比较不同血浆游离肉碱水平的重度创伤性脑损伤患者的相关资料,并采用Logistic多因素模型分析重度创伤性脑损伤患者低血浆游离肉碱水平的危险因素。结果重度脑创伤患者伤后12、24 h、伤后2、3及5 d血浆游离肉碱水平均低于对照组(P<0.05);预后良好组患者伤后血浆游离肉碱水平显著增高(P<0.05),预后良好组患者伤后12、24 h、伤后2、3及5 d血浆游离肉碱水平均高于预后不良组(P<0.05),重度创伤性脑损伤患者血浆游离肉碱水平与预后呈负相关(r=-0.423,P=0.005);游离肉碱<18μmmol/L组患者BMI、GCS评分及血尿素水平显著低于游离肉碱≥18μmmol/L组(P<0.05),游离肉碱<18μmmol/L组患者平均动脉压、肾小球滤过率及多发伤合并脑创伤显著高于游离肉碱≥18μmmol/L组(P<0.05);Logistic多因素分析显示肾小球滤过率及多发伤合并脑创伤是重度创伤性脑损伤患者低血浆游离肉碱水平的影响因素(P<0.05)。结论重度脑创伤患者血浆游离肉碱水平显著增高,并与预后呈负相关,肾小球滤过率及多发伤合并脑创伤是重度创伤性脑损伤患者低血浆游离肉碱水平的影响因素。
引文
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