Serum Gc-globulin in the early course of multiple trauma
Serum Gc-globulin in the early course of multiple trauma
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DOI：
10.1097/00003246-199802000-00027
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发表时间：
1998-02-01
影响因子：
8.8
通讯作者：
Tygstrup, N
中科院分区：
文献类型：
--
作者：
Dahl, P;Schiodt, FV;Tygstrup, N
目的：在多发伤患者中，受损细胞释放的肌动蛋白可导致血栓形成，引起严重的循环障碍。本研究的目的是评估血清中肌动蛋白清除剂Gc-球蛋白浓度与损伤严重程度和预后的关系。设计：前瞻性、纵向、观察性研究。设置：大学医院创伤中心。患者：12例多发性创伤患者，根据定义的标准连续入选。干预：无。测量和主要结果：血清GC-球蛋白浓度测定时，入院后每天1周或直至死亡。在所有患者中，Gc-球蛋白浓度明显较低（p < .0001），并且与肌动蛋白结合的Gc-球蛋白的比例在到达医院时已经高于正常值（p < .0001）。创伤后第一周血清Gc-球蛋白的平均浓度与损伤严重度评分呈负相关（r =-0.72，p <0.05）。存活的患者有一个显着（p <0.05）较高的浓度，血清GC-球蛋白在第一周后的创伤相比nonsurvivors.Conclusions：血清浓度的GC-球蛋白显着低创伤患者。骨折愈合时间均在伤后60 min内。因为GC-球蛋白的正常半衰期几乎是48小时，我们的观察结果表明，创伤后立即明显消耗GC-球蛋白。这一发现可能是第一个临床证据表明，GC-球蛋白在创伤后全身炎症反应综合征中发挥作用。这一结果得到了以下发现的支持，即缺乏GC-球蛋白与非存活率和创伤的严重程度有关。
Objectives: In patients with multiple trauma, actin released from damaged cells may cause severe circulatory disturbance due to thrombi formation. The aim of this study was to evaluate serum concentrations of the actin scavenger, Gc-globulin, in relation to the severity of injury and outcome.Design: Prospective, longitudinal, observational study.Setting: Trauma center at a university hospital.Patients: Twelve patients with multiple trauma, consecutively included, according to defined criteria.Interventions: None.Measurements and Main Results: Serum Gc-globulin concentrations were measured at the time of admission and daily thereafter for 1 wk or until death. In all patients, the Gc-globulin concentration was significantly low (p < .0001), and the proportion of Gc-globulin bound to actin was already increased compared with normal values (p < .0001) by the time of hospital arrival. There was an inverse correlation between the mean concentration of serum Gc-globulin in the first week after trauma and the Injury Severity Score (r = -0.72, p < .05). Surviving patients had a significantly (p < .05) higher concentration of serum Gc-globulin in the first week after trauma compared with nonsurvivors.Conclusions: Serum concentrations of Gc-globulin were significantly low in trauma patients. The reduction took place within 60 mins after injury. Because the normal half-life of Gc-globulin is almost 48 hrs, our observations suggest a marked consumption of Gc-globulin immediately after the trauma. This finding could be the first clinical evidence that Gc-globulin plays a role in the systemic inflammatory response syndrome after trauma. This result is supported by the finding that lack of Gc-globulin was related to nonsurvival and the severity of the trauma.