The Dynamic Changes Of Immunological And Correlative Biochemical Markers In Traumatic Brain Injury And Intervention Effect Of Urinary Trypsin Inhibitor In Clinical Control Research

[Background]:As the mechanism of traumatic brain injury has been understood by doctors,the death rate is decreasing a lot.But the complications,especial infection,get the chance to flourish,and those make high disability and mortality.The major reason lies in the chaotic immunological system.So we analyses the dynamic change of immunological and biochemical markers in traumatic brain injury,and we could offer references of diagnosis,treatment and prognosis.Meanwhile,we give patients urinary trypsin inhibitor(UTI),analyses the dynamic change of immunological and biochemical markers with expects of discover a new method to apply to the traumatic brain injury to elevate the curing rate.This article will divide into two parts to explain the results:Part 1:The dynamic changes and clinical manifestations of immunological and correlative biochemical markers in traumatic brain injuryObjective:Find the rules of dynamic changes of immunological and correlative biochemical markers in patient with traumatic brain injury,and give the reference of diagnosis,treatment and prognosis.Methods:Choose 36 patients,whose pre-hospital time was in 24 hours,diagnosed as traumatic brain injury to fulfill the research.And the date was restricted from Jan.2006 to Feb.2007.The values of CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺,CD₃₄⁺,NK cell and CRP,NSE,complement C₃ were detected at the first,third,fifth and seventh day.At the same time,15 persons were recruited as control.Results: Compared to control,CD₃⁺ was decreased greatly in the 1st day after trauma (P<0.05);CD₄⁺ was descended in the 3_rd,5_th and 7_th days after brain injury (P<0.01);And the CD₈⁺ was increased in the 7_th day post injury(P<0.05); The CD₄⁺/CD₈⁺ was elevated in 1^st(P<0.05),3^rd,5_th and 7_th days after injury (P<0.01);As to the CD₃₄⁺,it is higher than normal in 1^st,3^rd,5_th and 7_th days (P<0.01).Although descending,NK cell was proved higher than normal in all examining days(P<0.05).Complement C₃ was testified decreasing in the 1^st day,but higher than normal in the following days,reaching the apex in the 5_th day.Both CRP and NSE were increased in the first week(P<0.01),and then decreased gradually.Different data could be detected according to the degree of trauma.Conclusion:The imbalance of the immunological system is the most important factor in post-traumatic infection and prognosis.At the same time,biochemical data also can give us a better understanding of traumatic brain injury. Part 2:The therapeutic effect and mechanism to patients with traumatic brain injury by urinary trypsin inhibitorObjective:Exploring the therapeutic effect and mechanism of urinary trypsin inhibitor.Methods:Choose 22 patients,whose pre-hospital time was in 24 hours,diagnosed as traumatic brain injury to fulfill the research.And the date was restricted from Jan.2006 to Feb.2007.Urinary trypsin inhibitor twice a day to patients was prescribed from the first day in hospital,continuing 7 days.And the values of CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺,CD₃₄⁺,NK cell and CRP,NSE,complement C₃ were detected at the first,third,fifth and seventh day.Results:Compared to the contrast,CD₃⁺ was decreased greatly in the 5^th day after trauma(P<0.05);CD₄⁺ was increased greatly in the 5^th and 7^th days after brain injury(P<0.01);And the CD₈⁺ was decreased in the 5^th and 7^th days post injury(P<0.05);The CD₄⁺/CD₈⁺ was elevated in the 5^th and 7^th days after trauma(P<0.01);As to the CD₃₄⁺,it is decreased in the 1st day(P<0.05), while higher than normal in the 3_rd and 5_th days(P<0.01).NK cell was proved higher than normal in the 5^th and 7^th days(P<0.05).Complement C₃ was testified decreased a lot in the 5^th and 7^th days.Both CRP and NSE were decreased in the 5^th and 7^th days(P<0.05).The prognosis shows that patients treated with urinary trypsin inhibitor have a better outcome.And nothing was discovered concerning mortality.Conclusion:Urinary trypsin inhibitor can regulate the immunologic system and prevent the central nervous system from injury.