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| Clinical study on the Expression of Inflammatory Factors and Classification of Thoracic Trauma Severity Score in Patients with Chest Trauma |
| WU Yi-bin, LI Yi-ren, YANG Yi,et al |
| ICU,The Central Hospital of Xuhui District in Shanghai,Shanghai 200031 |
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Abstract Objective To study the relationship between the expression of inflammatory factors (like TNF-α) and classification of thoracic trauma severity score (TTS) in patients with thoracic trauma, and to investigate its role in the early prediction and assessment of clinical prognosis of patients. Method Sixty-four cases of hospitalized chest trauma patients in Department of Thoracic Surgery of our hospital from January 2014 to January 2016 were selected for the study. According to the thoracic trauma severity score (TTS score, total score 5~25 points), patients were classified as group A (35 severe cases with 16~25 points) and group B (29 mild cases with 5~15 points ). At the same time period, 40 cases of healthy volunteers were selected as the control group (group C). Collection of venous blood in group A and B were harvested on the onset of the first day, third day, and seventh day, and blood samples were collected in the control group as well at the same times. The inflammatory factors Hs-CRP and TNF-αwere detected and arterial blood characteristics including pH,PaCO2,PaO2 and SaO2 concentrations in blood gas were monitored in all three groups.The ELISA method was used to detect the dynamic changes of TNF- alpha index. Statistical software SAS9.3 was applied for data processing. Results The levels of hs-CRP and TNF-αin group A and group B showed a dynamic increasing within 24~72 hours after injury. The changes in group A were dramatically higher than those in group B. Three single factors were found by the statistical analysis including TTS scores, the serum TNF- level within 24 hours of onset and serum TNF- levels on the third day. They had significant predictive value in thoracic trauma patients who suffered multiple organ dysfunction syndrome (MODS).TTS scores combined with serum TNF-αlevels at 72 h showed the highest predictive value for thoracic trauma patients with MODS(AUC=0.9089). Indicators of pH, PaCO2, PaO2 and SaO2 in group A and B were significantly different from the control group C, there were also significant differences between group A and B in terms of PaCO2, PaO2 and SaO2 (P<0.05). Conclusion The severity of chest trauma can be evaluated by the TTS scores. The prediction value of thoracic trauma patients with MODS occurring can be improved significantly by the analysis of TTS scores combined with serum TNF-α levels.
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Received: 13 April 2017
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2017, Vol. 34 
