The Study On Serum Levels Of PCT And HMGB1 And Their Relations To Organ Disfunction In Patients With Severe Multiple Trauma

The recent research have indicated that organ disfunction and MODS have been one of the major complications and the reasones of death with the multiple trauma. Because there has no specific treatment measure, the death rate is quite high. With the steply development of understanding of organ disfunction and MODS, the clinic prevention and cure measure has been improved correspondingly, but the organ disfunction and MODS incidence rate and death rate has not been cut down. It has been not critically method to take earily pieriod forecasting the incidence of organ disfunction and MODS with multiple trauma for curing the syndrom.Objective The study was performed to study the level change of serum PCT and HMGB1 in patients with multiple trauma and to determine its relationship to severity of trauma score and organ disfunction . From the research, we can take good preparation for the next step large scale clinical experiments to forecast the incidence of organ disfunction and MODS.Method The study was performed as the following two aspects: 1.Observing the levels of serum PCT in patients with the multiple trauma of 26 cases in 24 hours after trauma, and estimating the score of ISS, APACHEII ,so that we can comprehend the relation between the levels of PCT and the score of ISS, APACHEII and the incidence of organ disfunction. 2. Observing the levels of serum HMGB1 in patients with multiple trauma of 35 cases in the l^st,3^rd,7^th day after trauma, and estimating the score of ISS, APACHEⅡ ,so that we can comprehend the relation between the levels of serum HMGB1 and the score of ISS, APACHEⅡ and the incidence of organ disfunction.Results1. The level of serum PCT in patients with ISS≤16 is lower than that of ISS>16(Z=-2.129, P=0.042), so did between the patients with APACHEII ≤20 andAPACHEII>20(Z=-2.117, P=0.034) ,and between the patients with OD and without OD (Z=-3.089, P=0.002).But is not so between the dead and living (Z=-1.307, P=0.191).2.The serum PCT level correlates with the incidence of organ disfunction(P=0.033) andAPACHEII(P=0.001).3.In the 1st day after trauma, the level of serum HMGBl in patients has no significance diferrence between the patients of ISS^ 16 and ISS>16 (t=-0.776, P=0.443), so did between the patients with APACHEII^20 and APACHEII>20(t=-1.200, P=0.239).4. In the 1st and 3rd day after trauma, the level of serum HMGBl in patients has significance diferrence between the patients of with OD and without OD (t=4.411, P=0.000, t=5.764, P=0.000).5. The HMGBl in the 1st ,3rd day correlat with the incidence of organ disfunction.6. When PCT^ lOng/ml, the probability of the incidence of organ disfunction is higher.7. When OD of HMGBl 5=4.01, the probability of the incidence of organ disfunction is higher in 1st day after trauma. When OD of HMGBl ^5.01, the probability of the incidence of organ disfunction is higher in 3rd day after trauma.Conclusions:1. The PCT correlates with the incidence of organ disfunction and APACHEII.2. The HMGBl in the 1st ,3rd day correlat with the incidence of organ disfunction.3. When PCT^10ng/ml, the probability of the incidence of organ disfunction is higher.4. When OD of HMGBl ^4.01, the probability of the incidence of organ disfunction is higher in 1st day after trauma. When OD of HMGBl ^5.01, the probability of the incidence of organ disfunction is higher in 3rd day after trauma.