Department of Emergency, Nanfang Hospital, Southern Medical University, Guangzhou, China.
J Trauma Acute Care Surg. 2013 Jan;74(1):254-8. doi: 10.1097/TA.0b013e318270db12.
This study aimed to examine the correlation between the alterations in serum sex hormones testosterone (T) and estradiol (E2) in the early stages after craniocerebral and extracranial injuries, to assess the Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) score in patients with multiple injuries, and to investigate the significance of the posttrauma changes in ISS and GCS as well as their ratio.
The serum levels of T and E(2) in 95 patients with multiple injuries in the early stages after trauma (within 24 hours) were determined by radioimmune double-antibody method. All the patients were classified by ISS, and among them, those complicated with craniocerebral injury were classified by GCS. The serum sex hormone levels and their ratio in the patients with trauma were compared with those in the control group consisting of 15 healthy persons.
In patients with multiple injuries, in the early stage after injury, the serum T level decreased in proportion with the severity of the trauma, whereas the E2 level increased. There was a significant difference in T, E(2), and the ratio of E(2) and T in the severely traumatic group (ISS > 25) as compared with the other groups (p < 0.01). Among the groups complicated with craniocerebral injury that were classified by GCS, there were significant differences in the groups of 5 ≥ GCS ≥ 3 and 8 ≥ GCS > 5, compared with the control group (p < 0.01).
The alterations in the serum sex hormones T and E2 levels and their ratio is correlated with the severity of trauma and craniocerebral injury and, thus probably, could serve as an indicator for the evaluation of the trauma severity and possibly in prognosis.
Prognostic study, level III.
本研究旨在探讨颅脑及颅外损伤后早期血清性激素睾酮（T）和雌二醇（E2）变化与损伤严重度评分（ISS）和格拉斯哥昏迷评分（GCS）的相关性，以及创伤后 ISS 和 GCS 变化及其比值的意义。
采用放射免疫双抗体法测定 95 例创伤后早期（24 小时内）多发伤患者的血清 T、E2 水平。所有患者按 ISS 分类，其中合并颅脑损伤者按 GCS 分类。比较创伤患者的血清性激素水平及其比值与 15 例健康对照者。
多发伤患者伤后早期 T 水平随创伤严重度降低，E2 水平升高，差异有统计学意义（p<0.01）；ISS>25 组 T、E2、E2/T 比值与其他组比较差异有统计学意义（p<0.01）。按 GCS 分类的颅脑损伤组中，5≥GCS≥3 组和 8≥GCS>5 组与对照组比较差异有统计学意义（p<0.01）。
血清性激素 T、E2 水平及其比值的变化与创伤和颅脑损伤的严重程度相关，可能作为评估创伤严重程度和预后的指标。
预后研究，III 级。
