顱腦損傷急性期血小板參數與外傷性腦梗死的關系_《華西醫學》

作者：

淡冰 ,  余水 , 曾令春 , 彭宗清 , 曾義軍 , 杜德明 , 鄭鋒 , 王強平

都江堰市人民醫院神經外科（四川都江堰，611830）;

關鍵詞：

顱腦損傷血小板預后

DOI：

10.7507/1002-0179.20130002

視頻：

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目的　探討顱腦損傷急性期血小板（PLT）參數與外傷性腦梗死（TCI）的關系。方法　選取2010年9月－2012年1月符合納入除標準的顱腦損傷患者191例。將傷后14 d內發生腦梗死的患者劃入觀察組，余為對照組。分別于傷后第24、48小時，第3、7、14天，采集肘靜脈血對PLT計數、PLT平均體積（MPV）、PLT體積分布寬度（PDW）；傷后24 h行格拉斯哥昏迷評分（GCS），傷后6個月隨訪行格拉斯哥結果評分（GOS）。分別分析腦梗死與上述PLT參數的關系、PLT參數與顱腦損傷病情輕重的關系以及與預后的關系。結果　觀察組PLT計數降低、MPV升高、PDW升高；觀察組患者GCS/GOS與PLT計數呈正相關，與MPV、PDW呈負相關。結論　PLT計數、MPV、PDW均與TCI有關，三者中PLT最具臨床意義。PLT計數越低、MPV和PDW越高，腦梗死可能性越大，顱腦損傷可能越嚴重，預后可能越差。

引用本文： 淡冰,余水,曾令春,彭宗清,曾義軍,杜德明,鄭鋒,王強平. 顱腦損傷急性期血小板參數與外傷性腦梗死的關系. 華西醫學, 2013, 28(1): 7-10. doi: 10.7507/1002-0179.20130002 復制

1.	Tawil I, Stein DM, Mirvis SE, et al. Osttraumatic cerebral infarction: incidence, outcome, and risk factors[J]. J Trauma, 2008, 64(4): 849-853.
2.	Tian HL, Geng Z, Cui YH, et al. Risk factors for posttraumatic cerebral infarction in patients with moderate or severe head trauma[J]. Neurosurg Rev, 2008, 31(4): 431-436; discussion 436-437.
3.	Ham HY, Lee JK, Jang JW, et al. Decompressive hemicraniectomy for the treatment of traumatic brain injury[J]. J Korean Neurosurg Soc, 2011, 50(4): 370-376.
4.	Oertel M, Kelly DF, Mcarthur D, et al. Progressive hemorrhage after head trauma: predictors and consequences of the evolving injuey[J]. J Neurosurg, 2002， 96(1): 109-116.
5.	劉衛平, 章翔, 易聲禹, 等. 大鼠急性顱腦損傷后膿微循環的變化[J]. 第四軍醫大學學報， 2000, 21(12) : 1506-1509.
6.	Matters M, Vemieri F, Troisi E, el al. Early cerebral heodynamic changes during passive movements and motor recovery after stroke [J]. J Neuml, 2003, 250(7): 810-817.
7.	Clark RS, Schiding JK, Kaczorowski SL, et al. Neutrophil accumulation after traumatic brain injury in rats: comparison of weight drop and controlled cortical impact models[J]. J Neurotrauma, 1994, 11(5): 499-506.
8.	鄧樹榮, 粱濤, 李洪韜, 等. 急性腦血管病血小板參數變化及臨床意義 [J]. 廣西醫科大學報, 2004, 21(5): 70l-703.
9.	Kurabayashi H, Tamura J, Naruse T, et al. Possible existence of platelet activation before the onset of cerebral infarction[J]. Atherosclerosis, 2000, 153(1): 203-207.
10.	Akisu M, Huseyinov A, Yalaz M, et al. Selective head cooling with hypothermia suppresses the generation of platelet-activating factor in cerebrospinal fluid of newborn infants with perinatal asphyxia [J]. Prostaglandins Leukot Essent Fatty Acids, 2003, 69(1): 45-50.
11.	Talving P, Lustenberger T, Lam L, et al. Coagulopathy after isolated severe traumatic brain injury in children [J]. J Trauma, 2011, 71(5): 1205-1210.
12.	Saggar V, Mittal RS, Vyas MC. Hemostatic abnormalities in patients with closed head injuries and their role in predicting early mortality [J]. J Neurotrauma, 2009, 26(10): 1665-1668.
13.	Talving P, Benfield R, Hadjizacharia P, et al. Coagulopathy in severe traumatic brain injury: a prospective study [J]. J Trauma, 2009, 66(1): 55-61.
14.	姚曉騰，荊國杰，謝乙團，等. 重型顱腦損傷患者亞低溫治療凝血功能指標的變化與預后[J]. 中國實用神經疾病雜志, 2011, 14(21): 3-7.
15.	曲東鋒. 腦出血后的抗血小板治療[J]. 國際腦血管病雜志, 2006, 14(3): 196.

1. 　Tawil I, Stein DM, Mirvis SE, et al. Osttraumatic cerebral infarction: incidence, outcome, and risk factors[J]. J Trauma, 2008, 64(4): 849-853.
2. 　Tian HL, Geng Z, Cui YH, et al. Risk factors for posttraumatic cerebral infarction in patients with moderate or severe head trauma[J]. Neurosurg Rev, 2008, 31(4): 431-436; discussion 436-437.
3. 　Ham HY, Lee JK, Jang JW, et al. Decompressive hemicraniectomy for the treatment of traumatic brain injury[J]. J Korean Neurosurg Soc, 2011, 50(4): 370-376.
4. 　Oertel M, Kelly DF, Mcarthur D, et al. Progressive hemorrhage after head trauma: predictors and consequences of the evolving injuey[J]. J Neurosurg, 2002， 96(1): 109-116.
5. 　劉衛平, 章翔, 易聲禹, 等. 大鼠急性顱腦損傷后膿微循環的變化[J]. 第四軍醫大學學報， 2000, 21(12) : 1506-1509.
6. 　Matters M, Vemieri F, Troisi E, el al. Early cerebral heodynamic changes during passive movements and motor recovery after stroke [J]. J Neuml, 2003, 250(7): 810-817.
7. 　Clark RS, Schiding JK, Kaczorowski SL, et al. Neutrophil accumulation after traumatic brain injury in rats: comparison of weight drop and controlled cortical impact models[J]. J Neurotrauma, 1994, 11(5): 499-506.
8. 　鄧樹榮, 粱濤, 李洪韜, 等. 急性腦血管病血小板參數變化及臨床意義 [J]. 廣西醫科大學報, 2004, 21(5): 70l-703.
9. 　Kurabayashi H, Tamura J, Naruse T, et al. Possible existence of platelet activation before the onset of cerebral infarction[J]. Atherosclerosis, 2000, 153(1): 203-207.
10. 　Akisu M, Huseyinov A, Yalaz M, et al. Selective head cooling with hypothermia suppresses the generation of platelet-activating factor in cerebrospinal fluid of newborn infants with perinatal asphyxia [J]. Prostaglandins Leukot Essent Fatty Acids, 2003, 69(1): 45-50.
11. 　Talving P, Lustenberger T, Lam L, et al. Coagulopathy after isolated severe traumatic brain injury in children [J]. J Trauma, 2011, 71(5): 1205-1210.
12. 　Saggar V, Mittal RS, Vyas MC. Hemostatic abnormalities in patients with closed head injuries and their role in predicting early mortality [J]. J Neurotrauma, 2009, 26(10): 1665-1668.
13. 　Talving P, Benfield R, Hadjizacharia P, et al. Coagulopathy in severe traumatic brain injury: a prospective study [J]. J Trauma, 2009, 66(1): 55-61.
14. 　姚曉騰，荊國杰，謝乙團，等. 重型顱腦損傷患者亞低溫治療凝血功能指標的變化與預后[J]. 中國實用神經疾病雜志, 2011, 14(21): 3-7.
15. 　曲東鋒. 腦出血后的抗血小板治療[J]. 國際腦血管病雜志, 2006, 14(3): 196.

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顱腦損傷急性期血小板參數與外傷性腦梗死的關系

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顱腦損傷急性期血小板參數與外傷性腦梗死的關系

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