| Objectives To test the dynamic change of the serum with IL-17, IL-18, c-reactive protein and HSP-70 in chest trauma over time, preliminary discuss on its relationship with pulmonary contusion, provide the basis for clinical diagnosis and treatment.Methods Collect the cases of chest trauma patients in our hospital from September2014 to September 2015 totle 51 cases as experimental group, 20 cases of healthy adults as control group. After admission of the patients with chest trauma, evaluation the degree of trauma according to the ISS, compute the score of ISS. Trauma admitted time control within 4 hours,according to the hospital emergency CT examination results divided into chest trauma patients without pulmonary contusion group and the group with pulmonary contusion, review chest CT on 3rd, 5th, 7th days after admission. Extraction of venous blood 5 ml on 1st,3rd,5th,7th days after admission respectively, 3000 r/min centrifugal and save in- 80 ℃ refrigerator for later use. Test the serum of IL-17,IL-18, CRP,HSP-70 with ELISA method, Observe these cytokines in serum concentration changes over the time, analysis the correlation of these factors with the degree of pulmonary contusion,provide the basis for clinical diagnosis and treatment.Results 1 71 cases ofthe object of study, 35 patients with pulmonary contusion group,16 patients with lung group fell and 20 healthy controls. Healthy control group of20 people, including 10 males and 10 women, aged 21 to 80 years old, average(46.76±17.06). For two groups of patients with chest trauma in statistical analysis have no statistical significance in age(t=0.66, P=0.51), gender composition(χ2=0.36,P=0.55).2 Pulmonary contusion patients admitted to hospital compared to no pulmonary contusion group with levels of serum IL-17 on the 1st,3rd,5th 7th days, IL-17 in the serum of patients with pulmonary contusion group concentration significantly higher than the corresponding number of days without pulmonary contusion group, differences were statistically significant(P<0.05). Two groups of patients compared with healthy controls,the levels of serum IL-17 were higher than in healthy controls on the 1st,3rd,5th 7th days. Pulmonary contusion group of patients with the concentration of serum IL-17 injured the extension of time, concentration obvious changes, the concentration of the IL-17 to the peak on the 3rd day and decline on the 5th,7th days, statistically have significant difference(P<0.05). 3 Patients with pulmonary contusion group on the 1st day after injury compared to no pulmonary contusion group have no difference between the concentration of serum IL-18. Pulmonary contusion patients admitted to hospital on 3rd, 5th, 7th days compared with no pulmonary contusion group of serum IL-18 levels respectively, The differences were statistically significant(P<0.05). Two groups of patients with serum concentration of IL-18 on the 1st,3rd,5th 7th days were higher than the healthy control group, the difference was statistically significant(P<0.05). Pulmonary contusion group of patients with the concentration of serum IL-18 injured the extension of time, concentration obvious changes, the concentration of the IL-18 to the peak on the3 rd day and decline on the 5th,7th days, statistically have significant difference(P<0.05).4 Pulmonary contusion patients admitted to hospital compared to no pulmonary contusion group with levels of serum CRP on the 1st,3rd,5th 7th days, CRP in the serum of patients with pulmonary contusion group concentration significantly higher than the corresponding number of days without pulmonary contusion group, differences were statistically significant(P< 0.05). Two groups of patients compared with healthy controls,the levels of serum CRP were higher than in healthy controls on the 1st,3rd,5th,7th days.Two groups of patients with serum CRP concentration as the extension of injury time, the concentration of the CRP to the peak on the 1st day and decline on the 3rd,5th,7th days,statistically have no significant difference(P>0.05). 5 Pulmonary contusion patients admitted to hospital compared to no pulmonary contusion group with levels of serum HSP-70 on the 1st,3rd,5th 7th days, There were no statistically significant difference(P>0.05). Two groups of patients with serum HSP-70 levels on the 1st,3rd,5th 7th days compared with healthy controls, there were no statistically significant difference(P>0.05).Twop groups with the concentration of the HSP-70 to the peak on the 3rd day and decline on the 5th,7th days,but statistically have no significant difference(P<0.05). 6 Pulmonary contusion patients admitted to hospital on the 1stand 3rd days, elevated the more significant of serum IL-17, IL-18 concentration with the more serious, statistically have significant difference(P<0.05). On the 3rd day, three groups of different levels of pulmonary contusion with the serum IL-17、IL-18 were reach to their peaks,and in a downward trend on the 5th, 7th days. Three groups of patients with pulmonary contusion with the serum IL-17、IL-18 significantly lower compared the 5th,7th days to the 1st day, differences have statistically significant(P<0.05). Compared the 3rd and 5th days there was no statistically significant difference(P>0.05). 7 Three groups of different levels of patients with pulmonary contusion serum CRP is at its peak on the 1st day of the hospital and on the 3rd, 5th, 7th days in a downward trend. With mild and moderate pulmonary contusion group decreased significantly relative to 1st day and 7th day,differences have statistically significant(P<0.05). Compared with 1st day with 3rd,5th are not obvious, there was no statistically significant difference(P>0.05). Patients with severe pulmonary contusion group serum CRP concentration decreased significantly relative to the 1st day and the 5th,7th days,differences have statistically significant(P<0.05). On the 7th day reduced significantly relative to the 3rd day, statistically significant difference(P<0.05). There was no significant difference compared with the1 st day and the 3rd day, there was no statistically significant difference(P>0.05).Conclusions 1 Pulmonary contusion group compared with no pulmonary contusion group and healthy control group,the serum of IL-17 concentration increased significantly,After injured on the 3rd day reach to its peak and on the 5th,7th days a downward trend.Severity of lung contusion and elevated serum IL-17 concentration degree were positively correlated. 2 Pulmonary contusion group compared with no pulmonary contusion group and healthy control group,the serum of IL-18 concentration increased significantly, After injured on the 3rd day reach to its peak and on the 5th,7th days a downward trend. Severity of lung contusion and elevated serum IL-18 concentration degree were positively correlated. 3 Patients with pulmonary contusion CRP were significantly elevated in the early pulmonary contusion and significantly higher than without pulmonary contusion group and healthy controls, pulmonary contusion more serious rise more significant, with the improvement of condition and gradually returned to normal,. 4 HSP-70 concentration in serum of patients in three groups have no obvious change. |
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