The Clinical Research On Coagulative Fibrinolytic And Inflammatory Markers In Acute Lung Injury At The Early Stage

Objective : To investigate the characteristic change and the influence of the coagulati- ve,fibrinolytic and inflammatory markers in patients with acute lung injury (ALI) at the early stage on the prognosis of ALI and get theory foundation for treatment.Methods : There were 22 cases with ALI ,male / female was 12/10,age was 61.59±10.39 years old ,and they were divided into two groups according to MODS or death respectively . Meanwhile 10 ICU controls and 10 healthy controls were included. Those accompanied with hematologic disease, liver disease or tumors were rejected .The parameters including PAI—1,t—PA,AT—Ⅲand IL—8 were measured among ALI group within three days, ICU controls and healthy controls by using ELISA or flocculent immunoassay and were compared and analyzed.Results:①There were no significant difference between ALI group,ICU controls and healthy controls on sex and age(P>0.05).②The PAI—1,t—PA,AT—Ⅲand IL—8 content of ALI group was 61.97±19.98ng/ml,8.41±2.60 ng/ml,155.24±62.33mg/l and 118.68±72.64pg/ml respectively. Those of ICU controls was 38.51±15.99 ng/ml, 5.30±3.11ng/ml,200.23±104.35mg/l and 88.24±91.90 pg/ml.Those of healthy controls was 8.75±6.74ng/ml,3.69±3.65ng/ml,232.09±23.60mg/l and 25.37±3.03pg/ml.The result of statistic analysis (F analysis and LSD-t test ) indicated that :the level of PAI—1 of ALI group was highest in three groups . it was the second higher in ICU controls ,which was higher than its in healthy controls.(P<0.01). In ALI group the levels of t—PA and IL—8 were higher and AT—Ⅲwas lower in significance (P<0.01)than those in healthy controls .③The level of PAI—1 and t—PA in MODS group was significantly higher, but AT—Ⅲlevel was lower than those in non-MODS group (P<0.05).while there was no significant difference in two groups on IL—8 level (P>0.05).④Compared with the survivors,the level of AT—Ⅲof patients who died was significantly lower ,and the level of IL—8 was significantly higher (P<0.05).while there was no significant difference on PAI—1 level and t—PA level (P>0.05).Conclusion :①The levels of PAI—1,t—PA,AT—Ⅲand IL—8 were obviously changed in ALI group ,which indicated that there were the coagulative,fibrinolytic and inflammatory obnormalities at ALI early stage .②The levels of PAI—1,t—PA and AT—Ⅲwere significantly changed in MODS group,which indicated that changes of coagnlative and fibrinolytic markers reflected the severity of the illness to some degree .③The levels of AT—Ⅲand IL—8 were changed in death group, which indicated that at ALI early stage high IL—8 or low AT—Ⅲlevel were perhaps the predictive markers of mortality.