Correlation Of Intracranial Pressure With Parameters Of Coagulation And T-lymphocyte Subsets In Patients Following Acute Moderate Traumatic Brain Injury:clinical Study

Objective:To investigate relationship between intracranial pressure and parameters of coagulation and T-lymphocyte subsets (CD4+T,CD8+T) in patients following acute moderate traumatic brain injury(TBI) and to provide some theoretical basis about the diagnosis and treatment of patients following acute TBI.Method:A study was performed using 42(30 males and 12 females) patients with acute TBI and17(11 males and 6 females) healthy controls taking a physis examination.All were assessed as acute moderate TBI patients with Glasgow Coma scale (GCS) and were performed with ICP monitoring .The patents were divided into three groups according to ICP:normal ICP group(6-15mmHg),Slightly elevated ICP group(15-20mmHg),moderately elevated ICP group(20-40mmHg).The prothrombin(PT),activated partial thromboplastin time(APTT),thrombin time(TT),Fibrinogen(Fg),D-Dimer(D-D),T-lymphocyte subsets (CD4+,CD8+,CD4+/ CD8+) and ICP were observed.Result:The levels of PT in patients with normal ICP,Slightly elevated ICP,moderately elevated ICP were siginificantly diffirent from healthy controls (P<0.05 or P<0.01). The levels of APTT and D-D in patients with slightly elevated ICP,moderately elevated ICP were siginificantly diffirent from healthy controls (P<0.05 or P<0.01). The levels of TT in patients with moderately elevated ICP were siginificantly diffirent from healthy controls (P<0.05). The levels of Fg in patients with normal ICP,slightly elevated ICP,moderately elevated ICP were siginificantly diffirent from healthy controls(P<0.05 or P<0.01). The levels of PT,APTT and D-D in patients with moderately elevated ICP were siginificantly diffirent from normal ICP (P<0.05).2.The levels of CD4+ and (CD4+/ CD8+)in patients with slightly elevated ICP,moderately elevated ICP were siginificantly diffirent from healthy controls(P<0.01). The levels of CD8+ in patients with normal ICP,slightly elevated ICP,moderately elevated ICP were siginificantly diffirent from healthy controls(P<0.05 or P<0.01). The levels of CD4+ in patients with slightly elevated ICP and moderately elevated ICP were diffirent from healthy controls(P<0.05 or P<0.01).Conclusion:1. There be abnormal coagulation in patients following acute moderate TBI and the degree of coagulation dysfunction will increase with ICP elevation.It shows that variation of coagulation parameters is relevant with ICP.and the study may be provide some new ideas for clinical diagnosis and treatment of patients with TBI.2. The levels of CD4+ decreased and the levels of CD8+ increased in patients following acute moderate TBI and changes of levels of CD4+ and CD8+ were more siginificant with the elevation of ICP.it showedthat the abnormality of immune function was more siginificant with the elevation of ICP in patients following acute moderate TBI.