The value of serum gelsolin, procalcitonin, homocysteine, cardiac troponin Iin diagnosis of multiple trauma severity and prognosis evaluating / 中国医师进修杂志

ABSTRACT

Objective:To analyze the value of serum gelsolin (GSN), procalcitonin(PCT), homocysteine (Hcy), cardiac troponin I(cTnI) in diagnosis of multiple trauma severity and prognosis evaluating.Methods:A retrospective analysis of 60 patients with multiple trauma from January 2019 to May 2020 in Liaocheng People′s Hospital were enrolled. According to injury severity score (SSA), the patients were divided into mild group (ISS ≤ 25 scores, 22 cases) and severe group (ISS>25 scores, 38 cases); according to prognosis, the patients were divided into survival group (38 cases) and death group(32 cases); 60 cases (control group) were included in the same period healthy volunteers. The levels of GSN, PCT, Hcy, cTnI were detected by enzyme-linked immunosorbent assay. The patients were followed up to 7 d, and the relationship between the above four serum items andinjury severity and survival rate were analyzed.Results:Before treatment, the level of GSN from low-to-high was severe group, mild group and control group; the levels of PCT, Hcy, cTnI from low-to-high was control group, mild group and severe group, and the differences were statistically significant ( P<0.05). After treatment, the level of GSN in mild group and severe group was increased, and the levels of PCT, Hcy, cTnI were decreased. Compared with those before treatment, the differences were statistically significant ( P<0.05). The level of GSN in the death group was lower than that in the survival group (137.87 ± 9.54) mg/L vs. (190.32 ± 9.32) mg/L, the levels of PCT, Hcy, cTnI in the death group were higher than those in the survival group (2.95 ± 0.32) μg/L vs. (0.44 ± 0.12) μg/L, (31.29 ± 8.54) μmol/L vs. (13.95 ± 2.19) μmol/L, (0.081 ± 0.007) μg/L vs.(0.020 ± 0.003) μg/L, and the differences were statistically significant ( P<0.05). The correlation analysis showed that the level of GSN had negative correlation with scale for the assessment of positive symptoms Ⅱ(SAPSⅡ) ( r = - 0.65, P<0.05) and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)( r = - 0.74, P<0.05), and the levels of PCT, Hcy, cTnI had positive correlation with SAPSⅡ( r = 6.18, 7.09, 9.15, P<0.05) and APACHEⅡ( r = 6.93, 7.32, 10.03, P<0.05). Multiple-factor analysis showed that serum GSN was a protective factor for survival rate, and serum PCT, Hcy, and cTnI were risk factors for survival rate ( P<0.05). Conclusions:The levels of serum GSN, PCT, Hcy, CTNl can assist in judging the severity and prognosis of multiple trauma. It is recommended to use it in combination with SAPSⅡ and APACHEⅡ.