Plasma gelsolin is reduced in trauma patients
Plasma gelsolin is reduced in trauma patients
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DOI：
10.1097/00024382-199908000-00002
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发表时间：
1999-08-01
期刊：
影响因子：
3.1
通讯作者：
Lee, WM
中科院分区：
文献类型：
--
作者：
Dahl, B;Schiodt, FV;Lee, WM
组织损伤导致细胞内蛋白肌动蛋白释放，该蛋白被血浆蛋白凝胶和gc -球蛋白从循环中清除，构成细胞外肌动蛋白清除系统（EASS）。实验研究表明，血液循环中过量的肌动蛋白可导致类似多器官功能障碍综合征（MODS）的疾病，我们之前已经证明，严重创伤后gc -球蛋白水平会下降。本研究的目的是确定创伤后早期血浆凝胶水平是否发生改变。对23例连续创伤患者进行了研究。用自制的兔抗人凝胶免疫比浊法测定血浆样品中的凝胶含量。从受伤到第一次采血的中位时间为52分钟（范围20-110），中位损伤严重程度评分（ISS）为20（范围4-50）。与正常对照相比，创伤患者入院时凝胶水平明显降低。中位水平为51 mg/L(7-967) vs. 207 mg/L(151-621), P < 0.0001。gelsolin的入院水平与ISS或生存率之间没有相关性。本研究表明，创伤后血浆凝胶浓度立即显著降低。需要进一步的研究来确定gelsolin或EASS在创伤患者MODS发生中的作用。血清或血浆明胶水平可以用浊度测定法快速准确地测定。
Tissue injury results in the release of the intracellular protein actin which is cleared from the circulation by the plasma proteins gelsolin and Gc-globulin, constituting the Extracellular Actin Scavenger System (EASS). Experimental studies have shown that excessive amounts of actin in the circulation can lead to a condition resembling multiple organ dysfunction syndrome (MODS), and we have previously demonstrated that the level of Gc-globulin is decreased after severe trauma. The purpose of the present study was to determine whether the plasma levels of gelsolin were altered in the early phase after trauma. Twenty-three consecutive trauma patients were studied. Plasma samples were assayed for gelsolin by immunonephelometry with polyclonal rabbit antihuman gelsolin prepared in our own laboratory. The median time from injury until the time the first blood sample was taken was 52 min (range 20-110) and the median Injury Severity Score (ISS) was 20 (range 4-50). The gelsolin level on admission was reduced significantly in the trauma patients compared with normal controls. The median level was 51 mg/L(7-967) vs. 207 mg/L (151-621), P < 0.0001. There was no correlation between admission levels of gelsolin and ISS or survival. This study illustrates that the plasma concentration of gelsolin is significantly diminished immediately after traumatic injury. Further studies are necessary to establish a role for gelsolin or EASS in the development of MODS in trauma patients. The level of serum or plasma gelsolin can be determined rapidly and accurately using a nephelometric assay.