| Objective:1.detect the contents of VEGF,vWF and IL-10 in the different time after injury of the severe lung contusion patients,and reveal their pathophysiological process and dynamic changing rules.2.approach the relationship of inflammatory reaction and the changing of blood clotting function after severe pulmonary contusion with acute traumatic lung injury furthermore,and consummate the recognition of the mechanisms of acute traumatic lung injury.3.study the dependability of VEGF,vWF and IL-10,and provide for us the new way and methods in treating severe acute traumatic lung injury.Methods:1.pulmonary contusion group:63 multiple injury complicating pulmonary contusion patients were selected,including 44 men and 19 women,their average age was 35.19±16.56.they were all consistent with the diagnostic criteria pulmonary contusion.The cases were dived into common or severe group according to "the simple grade of pulmonary contusion":the severe pulmonary contusion caused acute lung injury group(13～18 cents) was A group,total number was 32,including 21 men and 11 women, the average age was 32.07±17.71,the APACHEII is 17.44±3.21;and common group(1～12 cents) was B group,total number was 31,including 23men and 8 women,the average age was 36.34±9.29.2.positive control group(C group):30 multiple injury but not yet complicating pulmonary contusion patients were selected:including 20 men and 10 women,the average age was 37.44±11.14.3.normal control group(D group):30 healthy body check cases were selected,the choosing standard was:acute or chronic infection did not occurrence in the near future,and had no trauma.The cases including 20 men and 10 women,the average age was 27.3±10.8,age and sex were matched with A group,and statistical treatment difference was quiet(p＞0.05).Level of VEGF,vWF,IL-10 were determined by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA).4.The clinical results were compared.4,statistics method:all data were reported in mean±SD deviation,and progressed t check-up adopting spss17.0.It adopted spearman rank correlation in progressing correlation analysis.Size of test was p＜0.05.Results:1.The content of VEGF in blood serum of the patients who caused by multiple injury complicating pulmonary contusion had dynamic expression,and it increased immediately after injury and highest expression occurred at day 5,while it descended at day 7.The content in A group was significantly increased at each time points compared with control group(p＜0.01).The content in B group closed to normal level at day 7,and had no significance at each time points compared with controls(p＞0.05).2.Expression of vWF has the same change.3.The content of IL-10 in blood serum of the patients who caused by multiple injury complicating pulmonary contusion in A group increased immediately after injury within 24hour,and increased gradually in the following days.It had significance compared with B and D groups(p＜0.01).4.The content of vWF in blood plasma had positive correlation with the content of VEGF in blood serum,and they statistical significance(r=0.635,p＜0.01).5.The ALI patients who caused by multiple injury complicating severe pulmonary contusion were more than control groups,and mechanical ventilation time were longer than control groups(p＜0.05).Conclusion:The patients who had multiple injury complicating severe pulmonary contusion caused ALI easily,and the content of VEGF,vWF and IL-10 increased and showed a dramatic change.It indicated they involved in the pathophysiological process of pulmonary contusion,and it further confirmed the inflammatory reaction and blood clotting function changes after pulmonary contusion.The change tendency of VEGF and vWF in traumatic ALI revealed their distinctive position in the generation and development of ALI.It offered us the reference of the remover and prognosis of traumatic ALI,and offered new direction in treatment. |
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