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Objective To study the value of heart-type fatty acid-binding protein(H-FABP)for the early diagnosis of blunt cardiac injury(BCI).Method A prospective stuay was carried out in 42 patients,who suffered from blunt thoracic injury and were admitted from January 2007 to June 2008,and another42 heathy individuals in the health center of the Shanghai Fifth Hospital were recruited as control.Serum H-FABP,cTn Ⅰ and Myo levels of both healthy individuals and petients at 3,6 and 12 hours after trauma were measured by using ELLSA.Serum cTn Ⅰ levels was taken as a golden standard for the diagnosis of BCI.Accroding to serum cTn Ⅰ levels.42 patients with blunt thoracic injury were divided into group of patient with myocardial damage(13 patients)and group of patients without(29 patients).The receiver operating characteristic curves(ROC)of H-FABP and cTn Ⅰ in the diagnosis of BCI drawed at 3,6 and 12 hours after trauma,respectively,and the areas under curve(AUC)of ROC were compared.The values of H-FABP and cTn Ⅰ for diagnosing at 3,6 and 12 hours after trauma were analyzed Differences in serum H-FABP,cTn Ⅰ and Myo concentrations between groups were compared by Kruskal Wallis tegt.The delong.clarkepearson test was used to compare the areas under the ROC curves.Results AUCH-FABP and AUCcTn Ⅰfor diagnosing BCI at 3 hours after trauma were 0.9257 and0.6844,respectively,and AUCH-FABF was significantly more than AUCcTn Ⅰ(P=0.0125).AUCH-FABP,was significantly less than AUCcTnⅠ(0.9841 vs0.8276,P=0.0278)for diagnosing BCI at 12 hours after trauma.There was no significant difference in diagnosing BCI between AUCH-FABp and AUCcTn Ⅰat 12 hours after trauma(0.9655 vs.0.9125,P=0.2609).Conclusions H-FABP is valuabe in the early diagnosis of BCI,and its sensitivity is higherthanthat of cTnⅠ in diagnosing BCI at 3 hours after trauma.
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Objective To discuss the change of injury causes,ages and injury spectrum of traumatic inpatient recent years.Methods Clinical data of traumatic inpatient from 2000 to 2004 were analyzed.A total of 2 319 cases with trauma were divided into four groups:adolescent group (＜13 years old),youth group (13～44 years old),middle age group (45～64 years old) and elderly group (≥65 years old).Traumatic condition was evaluated by abridged injury score-injury severity score (AIS-ISS) Results From 2000 to 2004,the number of traumatic inpatient increased every year.In all cases,youth and middle age accounted for 87%.Traffic accident was the leading cause of injury,and injury by fall from height acted as the secondary injury cause in youth group and middle age group,as well as slip fall injury in adolescent group and elderly group.Of all cases,there were slight trauma (AIS＜3 or ISS＜16) in 1 335 cases,severe trauma (AIS≥3 or ISS≥16) in 984 case.Operation was performed in 1 249 cases and nonoperation was performed in 1070 cases.In all groups,73 patients were died.The overall mortality rate was 3.14%.Conclusion With the development of society,the occurrence rate of trauma increases accordingly.The youth and middle age were high risk groups.It was necessary and urgent to strengthen the traffic administration and carry out education on safety so as to decreas the incidence of trauma caused by all kinds of factors.