335 Medical Evacuation Regiment, Queen Elizabeth Barracks, York, UK; East Anglian Air Ambulance, Norwich, UK.
Tripler Army Medical Centre, Honolulu, HI, USA.
J Crit Care. 2018 Feb;43:312-315. doi: 10.1016/j.jcrc.2017.08.047. Epub 2017 Sep 1.
To study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL) and military blast and gunshot wound (GSW) to establish whether potential exists for NGAL as a biomarker for blast lung injury (BLI).
Patients from the intensive care unit (ICU) of the Role 3 Medical Treatment Facility at Camp Bastion, Helmand Province, Afghanistan were studied over a five month period commencing in 2012. Age, mechanism, trauma injury severity score (TRISS) and serum NGAL were recorded on ICU admission (NGAL1). Serum NGAL (NGAL2) and PaO/FiO ratio (P/F ratio2) were recorded at 24h.
33 patients were injured by blast and 23 by GSW. NGAL1 inversely correlated with TRISS (p=0.020), pH (p=0.002) and P/F ratio 2 (p=0.009) overall. When data was stratified into blast and GSW, NGAL1 also inversely correlated with P/F ratio 2 in the blast injured group (p=0.008) but not GSW group (p=0.27).
Raised NGAL correlated with increased severity of injury (worse survival probability i.e. TRISS and low pH) in both patient groups. There was an inverse correlation between admission NGAL and a marker of blast lung injury (low P/F ratio) at 24h in blast injured group but not GSW group that warrants further investigation.
研究血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）与军事爆炸和枪击伤（GSW）之间的关系，以确定 NGAL 是否有可能成为爆炸肺损伤（BLI）的生物标志物。
在 2012 年开始的五个月期间，研究了来自阿富汗赫尔曼德省坎巴松营地 3 号医疗设施重症监护病房（ICU）的患者。记录 ICU 入院时的年龄、机制、创伤严重程度评分（TRISS）和血清 NGAL（NGAL1）。在 24 小时时记录血清 NGAL（NGAL2）和 PaO/FiO 比值（P/F 比值 2）。
33 名患者因爆炸受伤，23 名因 GSW 受伤。总体而言，NGAL1 与 TRISS（p=0.020）、pH（p=0.002）和 P/F 比值 2（p=0.009）呈负相关。当数据分层为爆炸和 GSW 时，NGAL1 也与爆炸伤组的 P/F 比值 2 呈负相关（p=0.008），但与 GSW 组无关（p=0.27）。
升高的 NGAL 与两组患者的损伤严重程度（即 TRISS 和低 pH 值表示的生存概率降低）呈正相关。在爆炸伤组中，入院时的 NGAL 与 24 小时时的爆炸肺损伤标志物（低 P/F 比值）呈负相关，但在 GSW 组中无相关性，这值得进一步研究。
