Dynamic Changes Of Platelets And White Blood Cells In Humans After Traumatic Brain Injury

Object:This study was designed to observe the dynamic changes of platelets (PLTs) and white blood cells(WBCs) in the peripheral blood of patients after traumatic brain injury,to investigate the relationship between PLTs,W-BCs and the changes and prognosis of the patient's condition;to explore the influence of infection and inflammation on hypercoagulative state;to investigate the relationship between CRP and TSP1 in the interaction of inflammation and thrombosis;to lay the foundation for clinical treatment of TBI.Method:63 cases of patients suffered from traumatic brain injury was randomly selected as subjects of study,Another 10 cases of healthy people served as controls. Patients was divided into different groups by with or without infection and the Glasgow outcome score.Patients' blood were taken the first time within 24 hrs after TBI,then at 4 DPI(days post injury),7 DPI,14 DPI and 21 DPI.After separation of serum,the specimens was placed at -80℃in Low Temperature Freezer.The number of PLTs and WBCs were examined in 63 patients with TBI using cytoanalyze.The concentrations change of C reactive protein(CRP) and thrombospondin 1(TSP1) in peripheral blood of patients at every selected time-point were measured using Enzyme-Linked Immunosorbent(ELISA) and Micro plate spectrophotometer.The results were statistically analyzed.Result:PLTs in the peripheral blood of patients with traumatic brain injury was significantly higher compared with the normal group in the later stage of TBI.The number of WBCs in the peripheral blood of patients was significantly higher within 24 hrs after TBI,declining rapidly from 2DPI to 4DPI,rising again in the 7 DPI,then returned to normal levels gradually.According to the Glasgow outcome score,we found that the number of PLTs in the peripheral blood of patients with unfavorable outcome was significantly higher compared with favorable outcome group and the normal group.The number of WBCs in the peripheral blood of infection patients with unfavorable outcome increased again from 7DPI to 14DPI,whereas that of PLTs increased significantly at the same period of time.The number of WBCs in the peripheral blood of all patients,whether concurred with infection or not,was significantly higher within 24 hrs after TBI. However,it decreased to the level below 10×l09/L in patients without infection, while remained significantly higher in those with infection as compared with naive patients.The concentration of TSP1 in the peripheral blood of TBI patients was positively correlated with that of CRP.Conclation:1.The signifcant increase of WBCs in the early stage of TBI course didn't mean that concurrent infection;The change of WBCs on 4DPI is a key indicator to provide evidences for indication of prophylactic antibiotic usage.2.Much attention should be paid to the dynamic change of PLTs in the peripheral blood of TBI patients from 14DPI to 21DPI so as to evaluate the condition of hypercoagulability which potentially caused by inflammatory response.If the PLTs increased,use anticoagulant therapy to prevent complication such as deep vein thrombosis,pulmonary embolism and ischemic brain injury,and to improve the prognosis of TBI.3.TSP1 and CRP may participate in thrombosis formation induced by inflammation.