Diagnosis And Evaluation Of Pulmonary Contusion By Yang's Index And Serum Specific Protein

Objective: To explore a new method for diagnosis and dynamic assessment of pulmonary contusion through comparing and analyzing Yang's index,blood lung specific proteins and trauma score with the volume of contused lung tissue.Methods: 1.Patients' contused volume of lung were assessed with 3 methods,3-dimension reconstruction,Yang's index,lobe depended estimation and chest OIS on the chest CT thin slice scans.The data of every group were compared with the data of 3-dimension reconstruction to explore the correlation between Yang's index and the degree of pulmonary contusion.2.Traumatic patients were divided into pulmonary contusion group and non-pulmonary contusion group according to chest CT examination on the third day after injury,and the contusion volume,Yang's index,chest OIS,ISS score,blood IL-6,PAI-1,PTX-3,TNF-?,and v WF concentrations were measured on the 1st day after admission.For patients in pulmonary contusion group,blood specific proteins were also measured on 3rd,5th,7th day after admission.Comparing the protein concentrations between the pulmonary contusion group and the non-contusion group and at different periods after the injury to explore specific markers for the diagnosis and evaluation of pulmonary contusion.Results: 1.The correlation analysis between the contusion degree assessed by 3-dimension reconstruction and Yang's index got a correlation coefficient r=0.87(95% CI,0.76-0.93).While the correlation analysis between the contusion degree assessed by 3-dimension reconstruction and the lobe depended estimation got a correlation coefficient r=0.83(95% CI,0.72-0.89).The correlation analysis between the chest OIS and Yang's index got a correlation coefficient r=0.83(95% CI,0.69-0.92).2.The concentration of IL-6 on the 3rd day after trauma was significantly higher than that in the non-pulmonary contusion group(p<0.05);the blood concentration of PTX-3 on the 1st day after injury was significantly lower than that in the nonpulmonary contusion group(p<0.05);PAI-1,TNF-? and v WF were not significantly different at each time point after injury compared with the no-contusion group.Conclusion:1.There is a good correlation between Yang's index and the volume of pulmonary contusion,also between Yang's index and the chest OIS,which means that Yang's index can be used to rapidly assess the degree of pulmonary contusion in patients according to CT images,and worth further study.2.The change of IL-6 concentration in peripheral blood is consistent with the pathophysiological development of pulmonary contusion,and reaches the peak on the 3rd day after trauma.Changes in the concentration of IL-6 in the blood can diagnose and dynamically assess pulmonary contusion.3.The concentration of PTX3 in the blood of patients with pulmonary contusion decreased on the first day after trauma,and then increased.The degree of decline may be a predictor of early lung contusion after trauma.4.The comprehensive evaluation of imaging combined with the detection of peripheral blood-specific protein molecules may be an effective method for predicting and evaluating the occurrence and development of pulmonary contusion,thus guiding clinical treatment.