摘要
目的:探讨下丘脑-垂体-肾上腺轴(Hypothalamic-pituitary-adrenal axis,HAP轴)功能对颅脑损伤(traumaticbrain injuries,TBI)预后影响。方法:收集2018年1月-2019年12月在武汉科技大学附属天佑医院住院的40例TBL患者资料为研究对象,其中轻型20例,中型12例,重型8例。所有患者检测第3天早晨8;00血清皮质醇,然后于当晚23:00口服1mg地塞米松,于次日晨8:00复测血清皮质醇水平。记录患者住院时间,肺部感染发生情况及3个月时格拉斯哥预后(COS)评分。结果:HAP轴良好组28例,HAP轴功能障碍组12例。其中在轻型TBl中,HAP轴功能障碍10%(2/20);中型TBl中,HAP轴功能障碍33.33%(4/12);重型TBI中,HAP轴功能障碍75%(6/8);以上3组之间进行比较,差异具有统计学意义(x^(2)=15.65,P<0.01)。HAP轴良好组住院时间均短于HAP轴功能障碍组,差异具有统计学意义(Р值分别为0.013,0.002,0.012)。HAP轴功能障碍组肺部感染发生率高于HAP轴功能良好组(x^(2)=21.3778,P=0.0000)。HAP轴良好组(4.78±0.41)与HAP轴功能障碍组(3.08±0.76)COS评分进行比较,差异具有统计学意义(t=9.2028,P=0.0000)。结论:HAP轴功能影响TBI临床结局。
Objective:To investigate the influence of the function of hypothalamic-pituitary-adrenal axis(HAP axis)on the prognosis of traumatic brain injuries,(TBI).Methods:The data of 40 TBI patients hospitalized in Tianyou Hospital affiliated to Wuhan University of Science and Technology from January 2018 to December 2019 were collected as the research objects,including 20 cases of mild,12 cases of medium and 8 cases of severe.All patients were tested for serum cortisol at 8:00 a.m.on the third day,then took lmg dexamethasone orally at 23:00 that night,and re-measured serum cortisol level at 8:00 a.m.the next day.The hospital stay,pulmonary infection and Glasgow Outcome Scale(GOS)score at 3 months were recorded.Results:There were 28 cases with good HAP axis and 12 cases with HAP axis dysfunction.Among them,HAP axis dysfunction was 10%(2/20)in light TBI.In medium TBI,HAP axis dysfunction was 33.33%(4/12).In severe TBI,HAP axis dysfunction was 15%(6/8).Comparing the above three groups,the difference was statistically significant(2=15.65,P<0.01).The hospital stay in HAP axis group was shorter than that in HAP axis dysfunction group,and the difference was statistically significant(P=0.013,0.002,0.012,respectively).The incidence of pulmonary infection in HAP axis dysfunction group was higher than that in HAP axis dysfunction group(2=21.3778,P=0.0000).The GOS score of HAP axis well group(4.780.41)was compared with that of HAP axis dysfunction group(3.080.76),and the difference was statistically significant(t=9.2028,P=0.0000).Conclusion:HAP axis function affects the clinical outcome of TBI.
作者
郐国虎
刘杰
蒋伟
KUAI Guo-h u;UU Jie;JIANG Wei(Department of Neurosurgery,Tianyou hospital affilicated to Wuhan university of science and technology,Wuhan 430064)
出处
《中国伤残医学》
2021年第10期10-12,共3页
Chinese Journal of Trauma and Disability Medicine
关键词
下丘脑–垂体–肾上腺
颅脑损伤
临床结局
Hypothalamic-pituitary-adrenal
Traumatic brain injuries
Prognosis
