SERUM C-REACTIVE PROTEIN IN PATIENTS WITH SERIOUS TRAUMA

被引：32

作者：

GOSLING, P

DICKSON, GR

机构：

[1] Biochemistry Department, Selly Oak Hospital, Birmingham

[2] Birmingham Accident Hospital, Birmingham

来源：

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 1992年 / 23卷 / 07期

关键词：

D O I：

10.1016/0020-1383(92)90070-9

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Daily serum c-reactive protein (CRP) concentration was monitored in 98 patients (26 female) admitted to the Major Injuries Unit (MIU) at Birmingham Accident Hospital following serious trauma. The mean (SD) increase in CRP concentration for 79 survivors and 19 non-survivors between days 1 and 2 after trauma were 69.5 (74.6) and 111.8 (59.0) mg/l/24 h, respectively (P=<0.001). By day 4 after trauma the mean serum CRP concentrations for survivors and non-survivors were 150.9 (76.9) and 233.4 (100.8) mg/l (P<0.001), respectively. Injury severity data were available for 50 patients. The mean (range) injury severity score was 25.2 (4-50), Glasgow coma scale 10.4 (3-15), revised trauma score 6.5 (3.39-7.8) and predicted survival 0.78 (0.02-0.99). Univariate regression analysis of serum CRP on days 1-5 after injury against revised trauma score and injury severity score, revealed an inverse correlation between day 1 serum CRP and Glasgow Coma Score (r= -0.306, P<0.05), but no correlation with injury severity score or predicted survival on any of the study days. The lack of correlation between serum CRP and injury severity or predicted survival, and the strong association with actual survival, suggests that the acute inflammatory response to serious trauma and subsequent complications, is an important determinant of outcome.

引用

页码：483 / 486

页数：4

共 15 条

[1] Baxter, Future perspectives in trauma and bum care, J. Trauma, 30, (1990)
[2] Boyd, Tolson, Copes, Evaluating trauma care: the TRISS method, J. Trauma, 27, (1987)
[3] Colley, Fleck, Goode, Et al., Early time course of the acute-phase protein response in man, J. Clin. Pathol., 36, (1983)
[4] DeCamp, Demling, Concepts in emergency and critical care: post-traumatic multisystem organ failure, JAMA, 260, (1988)
[5] Gewurz, Mold, Siegel, Et al., C-reactive protein and the acute-phase response, Adv. Intern. Med., 27, (1982)
[6] Hansborough, Moore, Eiseman, Shock and multiple organ failure, Shock, the reversible stage of dying, (1989)
[7] Kushner, Ganapathi, Schultz, The acute phase response is mediated by heterogenous mechanisms, Ann. N.Y. Acad. Sci., 557, (1989)
[8] Lewis, The local responses of the microcirculation to trauma, The Scientific Basis for the Care of the Critically Ill, (1985)
[9] Moody, Shakespeare, Batstone, The effects of septic complications upon the serum protein changes associated with thermal injury, Ann. Clin. Biochem., 22, (1985)
[10] Nuytinck, Goris, Weerts, Et al., Acute generalised microvascular injury by activated complement and hypoxia: the basis of the adult respiratory distress syndrome and multiple organ failure, Br. J. Exp. Pathol., 67, (1986)

← 1 2 →