Clinical Study On Biomarkers And Thoracic Trauma Severity Score Levels In The Prognosis Of Pulmonary Contusion

Objective: To research the differences of vWF, IL-6, IL-10, APC, TTS score inpulmonary contusion patients,to investigate the correlation between pulmonary contusionprognosis of patients and plasma levels and the scores, and to explore its values of theearly prediction of severity and prognosis in patients with pulmonary contusion.Method: Patients with pulmonary contusion admitted to emergency department andICU of the First Affiliated Hospital of Soochow University, Wuxi First People’s Hospital,Yancheng People’s Hospital from December2012to November2013were enrolled.Inclusion criteria:1injured within24hours of admission;2meets the diagnostic criteriafor pulmonary contusion;3hospital stay for seven days. Exclusion criteria:1data wereincomplete;2previous merger heart, lung and kidney liver dysfunction. A total of55casesincluded in the study, including36males and19females, mean age35.19±16.56years.Patients were divided into ARDS group and non-ARDS group according to thediagnostic of ARDS.ARDS group is divided into survival group and non-survival,MODSgroup and non-MODS group, sepsis group and non-sepsis group judged by prognosis.30healthy subjects were selected as control,20males and10females, mean age of27.3±10.8years.The age and gender were comparable with experimental groups. clinical data ofpatients(including ISS、 TTS、 APACHEII score)were collected within24hours ofadmission.We collected the venous blood on admission (within6hours after injury), thefirst day after injury, the third, the fifth day and the seventh day to detect vWF, IL-6, IL-10,APC. Data was analyzed using SPSS17.0for processing.Results:1.Significant differences in hypovolemic shock, MODS, ISS,TTS, CRP werefound between ARDS group and non-ARDS group,normal group(P<0.05);no significant differences in CRP were found between non-ARDS group and normal group(P>0.05).2.Significant differences in mechanical ventilation,ICU stay time,mortality werefound between ARDS group and non-ARDS group.3.vWF, IL-6, IL-10, APC were significantly different between non-ARDS group andthe control group,then began to recover to normal in the next5-7days. vWF, IL-6, IL-10,APC of ARDS group recovered a lit through active treat, but with the progression of thedisease they would continue to abnormal and continued the first seven days.4.Significant differences in vWF, IL-6, IL-10, APC were found between ARDS groupand non-ARDS group on five different time(P<0.05).5.There was positive correlation between vWF, IL-6and IL-10,and negativecorrelation between vWF, IL-6,IL-10and APC on admission.6.The value in predicting ARDS when blood markers combined TTS score was thehighest(AUC=0.877).7.Significant differences in TTS,vWF, IL-6, IL-10, APC were found betweennon-survival group, MODS group, sepsis group and corresponding control groups onadmission (P<0.05).Conclusion:1.vWF, IL-6, IL-10, APC were involved in the pathophysiology ofpulmonary contusion occurring ARDS,and provide a reference of the prognosis for patientswith ARDS.2.Combination of markers (vWF, IL-6, IL-10, APC) joint TTS score on admission hadmore predictive values in lung contusion patients occurring ARDS.3.TTS score predicted poor prognosis in pulmonary contusion patients and wassuitable for severity assessment and prediction of outcome.