Time course of early and late changes in plasma DNA in trauma patients
Time course of early and late changes in plasma DNA in trauma patients
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DOI：
10.1373/49.8.1286
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发表时间：
2003-08-01
影响因子：
9.3
通讯作者：
Lo, YMD
中科院分区：
文献类型：
--
作者：
Lam, NYL;Rainer, TH;Lo, YMD
背景：创伤后患者循环中的游离 DNA 浓度增加，可能具有预后潜力，但对于 DNA 的时间变化或清除或其与创伤后并发症的关系知之甚少。我们利用实时定量 PCR 研究了创伤后患者血浆 DNA 浓度的时间变化。方法：从两个创伤人群中采集连续血浆样本。在第一项研究中，在创伤后的前 3 小时内，每 20 分钟从 25 名患者身上采集一次样本。在第二项研究中，每天从入住重症监护病房 (ICU) 的其他 36 名创伤患者身上采集样本。结果：在第一项研究中，血浆 DNA 在受伤后 20 分钟内增加，并且在严重损伤的患者和随后发生器官衰竭的患者中显着升高。在损伤较轻的患者中，血浆 DNA 浓度在 3 小时内下降至参考值。在第二项研究中，入院第二天到第四天出现多器官功能障碍综合征的患者血浆 DNA 浓度高于未出现该综合征的患者。在因持续器官功能障碍而留在 ICU 的患者中，即使在受伤后 28 天，血浆 DNA 仍高于健康对照组。大多数患有多器官功能障碍综合征的幸存者表现出最初的非常高的峰值，然后是长期较小的增加。结论：血浆 DNA 浓度在受伤后早期增加，并且在严重受伤的患者和发生器官衰竭的患者中更高。受伤后血浆 DNA 持续升高数天，尤其是患有多器官功能障碍综合征的患者。 (C) 2003 年美国临床化学协会。
Background: Cell-free DNA concentrations increase in the circulation of patients after trauma and may have prognostic potential, but little is know concerning the temporal changes or clearance of the DNA or its relationships with posttraumatic complications. We investigated temporal changes in plasma DNA concentrations in patients after trauma with use of real-time quantitative PCR.Methods: Serial plasma samples were taken from two trauma populations. In the first study, samples were collected every 20 min from 25 patients within the first 3 h of trauma. In the second study, samples were collected every day from 36 other trauma patients admitted to the intensive care unit (ICU).Results: In the first study, plasma DNA was increased within 20 min of injury and was significantly higher in patients with severe injury and in patients who went on to develop organ failure. In patients with less severe injuries, plasma DNA concentrations decreased toward reference values within 3 h. In the second study, plasma DNA concentrations were higher in patients who developed multiple organ dysfunction syndrome between the second and fourth days of admission than in patients who did not develop the syndrome. In patients who remained in the ICU with continuing organ dysfunction, plasma DNA remained higher than in healthy controls even at 28 days after injury. Most survivors with multiple organ dysfunction syndrome showed an initial very high peak followed by a prolonged smaller increase.Conclusions: Plasma DNA concentrations increase early after injury and are higher in patients with severe injuries and in those who develop organ failure. Increased plasma DNA persists for days after injuries, especially in patients with multiple organ dysfunction syndrome. (C) 2003 American Association for Clinical Chemistry.