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APACHEⅡ评分及IL-6在限制性液体复苏创伤失血性休克的意义

王爱田1,李晓岚2,高景利2,陈朔华2,张辉2,马宇杰2   

  1. 1. 开滦医院
    2. 华北煤炭医学院附属开滦医院
  • 收稿日期:2010-03-22 修回日期:2010-06-28 出版日期:2010-11-15 发布日期:2010-11-15
  • 通讯作者: 王爱田

The significance of APACHEⅡ and IL-6 in patients with traumatic hemorrhagic shock by limited fluids resuscitation

  • Received:2010-03-22 Revised:2010-06-28 Published:2010-11-15 Online:2010-11-15

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摘要： 摘要 目的 研究APACHEⅡ评分、炎性因子IL-6，IL-10在限制性液体复苏创伤失血性休克患者的意义。方法 选择106例创伤失血性休克患者，随机分为两组，一组为常规液体复苏组，另一组为限制液体复苏组，每组53人。另设健康对照组(20人)清晨抽取静脉血，留送IL-6、IL-10检测。观察两组在住院第1、3、5、7天检测血清IL-6、IL-10浓度，进行急性生理学及慢性健康状况评分(APACHEⅡ)，统计28天患者并发症发生率及死亡率。结果 两组IL-6, IL-10水平，显著高于对照组（p<0.01）；限制液体复苏组IL-6水平，显著低于常规液体复苏组；死亡组的IL-6浓度及APACHEⅡ评分高于存活组（p<0.01）；常规液体复苏组和死亡组IL-10浓度分别与限制液体复苏组和存活组比较差异无统计学差异（p>0.05）。两组并发症发生率及死亡率比较有统计学意义（p<0.05）；结论 限制性液体复苏能降低IL-6浓度，提高治愈率，降低死亡率，治疗效果优于常规液体复苏方法；早期进行APACHEⅡ评分及检测血清IL-6对预见患者的死亡率及并发症有重要临床意义。

关键词: 创伤, 休克, 液体复苏, 限制性, APACHEⅡ评分, IL-6, 预后

Abstract: ABSTRACT Objective This study was performed to investigate the significance of APACHEⅡ and IL-6 in patients with traumatic hemorrhagic shock by limited fluids resuscitation, Method 106 eligible patients with traumatic hemorrhagic shock were randomly divided into two groups and the healthy control group (n=20). The group of conventional liquid (n=53), Anohter group of limited fluids resuscitation (n=53). The blood samples were taken for lactate, IL-6, and IL-10 measurements. The Acute physiology and chronic health evaluation(APACHEⅡ) were calculated; complications and final clinical outcomes were monitored. Result IL-6, IL-10 in two groups were significantly higher than healthy control groups（p<0.01）.IL-6 in the group of limited fluids resuscitation were significantly lower than the group of conventional liquid （p<0.05）. IL-6 in the group of the non-survival group were higher than those in the group of survival group（p<0.01）.There were no obvious significances in IL-10 between two group（p>0.05）.There were obvious significances in complicationsand mortality（p<0.05）. Conclusion Limited fluids resuscitation can reduce the levels of IL-6, improve the crue rate, lower the daeth rate. Early test of IL-6 and calculated APACHEⅡscores in paitients with traumatic hemorrhagic shock can be used to evaluate the state of illness and prognosis

Key words: Trauma, Shock, Fluids resuscitation, Limited, APACHEⅡ, Interleukin-6, Prognosis