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创伤后大量失血致应激性溃疡患者血清 Hs-CRP 水平及临床意义。

Serum Hs-CRP level and clinical significance of patients with stress ulcer caused by massive blood loss after trauma.

机构信息

Department of Intensive medicine, Kailuan General Hospital, Tangshan, 063000, China..

Nursing Department Cangzhou Central Hospital of Hebei Province, China.

出版信息

Cell Mol Biol (Noisy-le-grand). 2022 Jan 2;67(4):189-194. doi: 10.14715/cmb/2021.67.4.21.

Abstract

Stress ulcer refers to a specific type of irritation of the inner wall of the gastrointestinal tract that occurs rapidly due to acute physiological stress such as severe disease, infection, or trauma. This study investigated the serum Hs-CRP level and clinical significance of patients with stress ulcers caused by massive blood loss after trauma. For this purpose, we studied 113 patients with enormous blood loss after trauma. During the study, 26 patients developed stress ulcers. Therefore, patients with massive blood loss after trauma were divided into two groups with and without stress ulcers. In addition to clinical and demographical evaluations, serum Hs-CRP levels were measured by ELISA test method in all patients at baseline, 6, and 12 days after starting the study. Results showed that 24 patients were excluded from the study due to termination of cooperation or death. Finally, 89 patients participated in the final analysis. Of these 89 patients, 26 developed stress ulcers. There was a significant difference between the two groups with stress and non-stress ulcers in terms of mean age (P=0.001) and gender (P=0.041). Also, there was a significant difference between the two groups regarding re-bleeding (P=0.012), the number of hospitalization days (P=0.001), and a decrease in hemoglobin (P=0.035). But there was no difference between the two groups regarding the need for re-surgery (P=0.276). The results of this study showed that increased serum hs-CRP levels are directly related to stress ulcers. Patients with higher serum Hs-CRP levels were more likely to develop stress ulcers than patients without stress ulcers during six days (P=0.04) and twelve days after starting the study (P=0.001). Current research results also show that the prevalence of stress ulcers occurs in men more than women. The risk of stress ulcers increases among older patients. People with stress ulcers also lose more hemoglobin, and finally, patients with more trauma and more extended hospital stays have a higher chance of developing stress ulcers.

摘要

应激性溃疡是指由于严重疾病、感染或创伤等急性生理应激而迅速发生的胃肠道内壁特定类型的刺激。本研究调查了创伤后大量失血引起的应激性溃疡患者的血清 Hs-CRP 水平和临床意义。为此,我们研究了 113 例创伤后大量失血的患者。在研究过程中,26 例患者发生了应激性溃疡。因此,将创伤后大量失血的患者分为有和无应激性溃疡两组。除了临床和人口统计学评估外,还通过 ELISA 测试方法测量了所有患者在研究开始后第 6 天和第 12 天的血清 Hs-CRP 水平。结果表明,由于合作终止或死亡,有 24 例患者被排除在研究之外。最后,有 89 例患者参与了最终分析。在这 89 例患者中,有 26 例发生了应激性溃疡。有应激性溃疡和无应激性溃疡的两组患者在平均年龄(P=0.001)和性别(P=0.041)方面有显著差异。此外,两组患者在再出血(P=0.012)、住院天数(P=0.001)和血红蛋白下降(P=0.035)方面也有显著差异。但两组患者在需要再次手术方面无差异(P=0.276)。本研究结果表明,血清 hs-CRP 水平升高与应激性溃疡直接相关。与无应激性溃疡的患者相比,在研究开始后第 6 天(P=0.04)和第 12 天(P=0.001)时,血清 Hs-CRP 水平较高的患者更有可能发生应激性溃疡。目前的研究结果还表明,应激性溃疡的发生率男性多于女性。年龄较大的患者发生应激性溃疡的风险增加。发生应激性溃疡的患者也会失去更多的血红蛋白,最后,创伤更多、住院时间更长的患者发生应激性溃疡的机会更高。

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