| Objective:There are diversities in the performance of heart damage after brain contusion and laceration, Such as arrhythmia, myocardial ischemia, pseudo myocardial infarction, heart failure and even cardiac arrest and a series of heart complications. Clinical and experimental in succession at home and abroad made the corresponding electrocardiogram, myocardial enzymes, echocardiography, and myocardial histopathology of abnormal changes. This study investigated the clinical significance of changes of the serum heart-type fatty acid binding protein (H-FABP) in patients with cerebral contusion;Methods:To study patients with cerebral contusion from December 2009 to February 2011 in the Neurosurgery ward of Third Xiangya Hospital,Central South University (Diagnose by the head CT scan after injury), excluded nearly one week of acute myocardial infarction, chest cardiac massage CPR, defibrillation, direct current cardioversion, chest trauma, thoracic surgery, myocarditis, chronic renal insufficiency and in patients with muscular diseases.40 cases of cerebral contusion were grouped according to GCS score:A group:3 to 4 points in 8 cases, B group:5 to 6 points in 8 cases, C group:7 to 8 points in 8 cases, D group: 9 to 12 points in 8 cases, E group:13 to 15 points in 8 cases, taking the blood from patients injured after 3h,6h,12h,24h,3 days,5 days,,7 days,14 days, examine the serum heart-type fatty acid binding protein by using ELISA (ELISA). Taking 8 normal as controls (F group). Detecting the H-FABP At the same time as judging GCS score; The use of Glasgow Outcome Scale (Glasgow outcome scale, GOS) on the experimental group were followed up for 3 months to determine the prognosis of the situationResults:(1)Experimental study of different groups within 14 days of the average concentrations of H-FABP were:A group:31.6±3.4ng/l; B group:26.5±4.1ng/l; C group:20.4±3.7ng/l; D group:12.8±4.3ng/l; E group:4.5±4.2ng/l; The control group (F group) H-FABP average concentration:1.2±0.4ng/1.H-FABP expression in the experimental group was significantly higher than the control group (P <0.01). The more serious condition (GCS score, the lower), H-FABP in patients with the higher average concentration,positive correlation between them. (2)H-FABP in patients with average concentration after 3 hours was 9.2±2.4ng/1, 6 hours was:16.3±1.8ng/l; 12 hours:23.6±4.5ng/l; 24 hours:32.6±4.8ng/l; 3 days was:25.8±3.4ng/l; 5 days was:13.6±2.7ng/l; 7 days was:8.3±3.1ng/l; 14 days was:4.2±2.6ng/l; Were significantly higher than normal at the same time point (P <0.01).(3) Within 24 hours after injury, H-FABP levels of A～E groups in patients were significantly higher, reached a maximum after 24 hours, A group with the most significant increase (GCS score, the lower, H-FABP increased more obvious). Explain that more serious illness, the body appears more obvious heart damage; In the process of gradual decline of H-FABP concentration after 24 hours, The fastest decline in E group, reached the normal level after 7 days, A group decline in the slow group the longest sustained increase, While the more serious condition (GCS score, the lower), H-FABP increased the longer, sustained heart damage appears longer. (4) Variance test analysis were done within each experimental group, It found that the greater the difference of GCS score of each group, H-FABP the more obvious changes, elaborate more severe disease, H-FABP increased the higher the degree, the longer it continued to increase(P<0.05); (5)The overall prognosis that the worst group A, E group the best prognosis were found through the use of GOS.Conclusion:(l)There is significantly higher plasma H-FABP in patients with cerebral contusion, H-FABP can be used as an early indirect biochemical indicators to judge the severity of cerebral contusion; (2) The more serious condition (GCS score, the lower), H-FABP increased, the more obvious the longer the sustained increase; (3) H-FABP in patients with cerebral contusion on the prognosis of early stage has important tips and guidance. |
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