Clinical Study Of Coagulation And Fibrinolysis Parameters In Plasma After Craniocerebral Trauma

Objective: To explore the alteration law and clinical significances of the three plasma sensitivity parameters (Tissue factor, D-dimer and Antithrombinlll activity) in forty patients with acute craniocerebral trauma and to evaluate the relationship between them and the severity of brain injury(GCS)and patients' outcomes(GOS). At the same time, to observe the their alteration characteristics in brain trauma patients with delayed traumatic intracerebral hematoma(DTIH) or enlargement of previously small hematomas.Methods: We detected the levels of TF, DD and ATIII activity in forty acute craniocerebral trauma patients by Chromogenic analysis method and latex-enhanced immunoturbidimetric test at three different time points(at admission third days after injury and seventh days after injury). Their levels were compared with control group. Then we classified the patients by the severity of trauma(GCS≤8 group and GCS >8 group)and outcomes (die group and alive group) and if developed delayed traumatic intracerebral hematoma (DTIH group and non-DTIH group) and compared the TF, DD and ATIII levels between the different groups. Finally we analyze the date with SPSS(version 13.0).Results: ① The levels of TF, DD and ATIII activity in trauma group were all higher at admission and The differences were significance(P<0. 01) compared with control group. The DD level of trauma group at 3d and 7d were still higher than control group(all P<0. 05). The level of TF declinedwith the lapse of time, But The ATITJ activity level present a run-up trend. ?The levels of the three parameters in GCS^8 group were all higher than GCS>8 group at three time point (all P<0. 01). ?The DTIH group TF levels at admission and at 3 day after trauma were high then that of non-DTIH group(P<0.01), but at 7 day after trauma, there was no statistically difference between two groups. Compared with non-DTIH group, the levels of DD and ATEH activity were all higher(all P<0. 05). ?There was all statistically differences when compared the three parameters levels of good outcome group with poor outcome group and die group(all P<0. 05). There was no statistically difference between poor outcome group and die group.Conclusion: Craniocerebral trauma patients present a state of hypercoagulability and secondary hyperfibrinolysis at early stage. At later stage, hyperfibrinolysis is prominent and may build in secondary craniocerebral injuries such as a DTIH. Through detecting the sensitivity parameters at earlier time after brain trauma, we can estimate the severity of brain injury and prognosticate the outcomes of the patients, the clinical value is remarkable.