Early change of blood coagulation in severe trauma patients and its relation with plasma thrombomodulin and protein C / 中华创伤杂志

ABSTRACT

ObjectiveTo investigate the early change of blood coagulation in severe trauma patients and its relationship with plasma levels of thrombomodulin (TM) and protein C.MethodsSixtyfour multiple trauma patients early admitted to the emergency department were divided into two groups according to the injury severity score ( ISS),severe trauma group ( ISS≥16 points) and slight trauma group ( ISS ＜ 16 points).Blood specimens were obtained immediately upon their arrival at hospital to comparatively analyze the changes of prothrombin time (PT) and activated partial thromboplastin time (APTT) in both groups.Meanwhile,plasma levels of TM and protein C were measured and analyzed for discussing their relationship with changes of blood coagulation.Another 30 healthy persons were taken as the control group.Levels of plasma TM and protein C between the death and survival were comparatively analyzed as well.ResultsPT and APTT in the severe traunma group (ISS ≥ 16 points) were significantly longer than those in the slight trauma group ( ISS ＜ 16 points) and the control group ( P ＜ 0.05 ),with significant correlation with plasma TM and protein C levels ( P ＜ 0.05 ).Plasma TM level in the death group was significantly higher than that in the survival group,but protein C level in the death group was significantly lower than that in the survival group.ConclusionsCoagulation abnormalities presenting early after severe trauma are correlated with activation of plasma TM and protein C.Levels of plasma TM and protein C demonstrate significant role in prediction of the prognosis in patients with severe trauma.