Nie Chan, Wang Tao, Yu Huiting, Wang Xue, Zeng Xueqin, Wei Zairong, Shi Xiuquan
Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China.
Burns & Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Medical University, Zunyi, Guizhou, China.
PeerJ. 2019 Feb 11;7:e6415. doi: 10.7717/peerj.6415. eCollection 2019.
Burn and traumatic injury are two kinds of injury by modality. They cause acute phase response and lead to a series of pathological and physiological changes. In this study, we explored whether there are differences in routine blood parameters and liver enzyme levels between burned and traumatically injured children.
Patients under 18 years old with injuries were recruited. Their demographic and clinical data were recorded. Collected clinical data included routine blood parameters (white blood cell count (WBC), red blood cell count (RBC), platelets (PLT), hemoglobin (HB)), serological enzyme levels (alanine aminotransferase (ALT), aspartate transaminase (AST), glutamyltransferase (GGT), alkaline phosphatase (ALP), cholinesterase (CHE)), and total protein (TP) levels (albumin (ALB), globulin (GLB)). A generalized linear model and multivariate analysis of variance were used to conduct comparisons.
A total of 162 children (109 with burns and 53 with traumatic injuries) with a mean age of 4.36 ± 4.29 years were enrolled in the study. Burned children had higher levels of RBC, HB, WBC, AST and lower levels of TP, CHE, ALB than traumatically injured children ( < 0.05). Moreover, the concentration of WBC and HB was higher in males compared to females ( < 0.001). Conversely, the level of AST and TP in males was lower, AST levels were significantly lower in males ( = 0.005). Age positively correlated with the levels of HB, AST and TP ( < 0.001), and negatively correlated with WBC ( < 0.001). With decreasing body mass index (BMI), the levels of WBC, HB, AST and TP significantly increased in both groups of injured children ( < 0.001). In addition, ISS was positively correlated with WBC and HB levels ( < 0.001), but negatively correlated with AST and TP levels ( < 0.001).
Children with burn injuries suffered a greater acute response and liver damage than traumatically injured children. This may in part underlie clinical observations of differences in children morbidity and mortality in response to different injury types.
烧伤和创伤性损伤是两种不同类型的损伤。它们会引发急性期反应，并导致一系列病理和生理变化。在本研究中，我们探讨了烧伤儿童和创伤性损伤儿童在血常规参数和肝酶水平上是否存在差异。
招募18岁以下的受伤患者。记录他们的人口统计学和临床数据。收集的临床数据包括血常规参数（白细胞计数（WBC）、红细胞计数（RBC）、血小板（PLT）、血红蛋白（HB））、血清酶水平（丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）、胆碱酯酶（CHE））以及总蛋白（TP）水平（白蛋白（ALB）、球蛋白（GLB））。采用广义线性模型和多因素方差分析进行比较。
本研究共纳入162名儿童（109名烧伤儿童和53名创伤性损伤儿童），平均年龄为4.36±4.29岁。烧伤儿童的RBC、HB、WBC、AST水平高于创伤性损伤儿童，而TP、CHE、ALB水平低于创伤性损伤儿童（P<0.05）。此外，男性的WBC和HB浓度高于女性（P<0.001）。相反，男性的AST和TP水平较低，男性的AST水平显著较低（P=0.005）。年龄与HB、AST和TP水平呈正相关（P<0.001），与WBC呈负相关（P<0.001）。随着体重指数（BMI）的降低，两组受伤儿童的WBC、HB、AST和TP水平均显著升高（P<0.001）。此外，损伤严重度评分（ISS）与WBC和HB水平呈正相关（P<0.001），但与AST和TP水平呈负相关（P<0.001）。
烧伤儿童比创伤性损伤儿童遭受更严重的急性反应和肝损伤。这可能部分解释了临床上观察到的不同类型损伤儿童发病率和死亡率差异的原因。
