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第四届长三角地区创伤学术大会暨2014年浙江省创伤学术年会

作者： Wen-Hua Yu Ding-Bo Yang Xiao-Qiao Dong Quan Du Yong-Feng Shen Zu-Yong Zhang Qiang Zhu Zhi-Hao Che Qun-Jie Liu Hao Wang Li Jiang Yuan-Feng Du Department of Neurosurgery The Hangzhou First People's Hospital Nanjing Medical University Affiliated Hangzhou Hospital

Higher plasma copeptin levels correlate with poor clinical outcomes after traumatic brain ***,their links with acute traumatic coagulopathy and progressive hemorrhagic injury are ***,we aimed to investigate the relationship between plasma copeptin levels,acute traumatic coagulopathy and progressive hemorrhagic injury in patients with severe traumatic brain *** prospectively studied 100 consecutive patients presenting within 6 hours from head *** hemorrhagic injury was present when the follow-up computerized tomography scan reported any increase in size or number of the hemorrhagic lesion,including newly developed *** traumatic coagulopathy was defined as an activated partial thromboplastic time greater than 40 seconds and / or international normalized ratio greater than 1.2 and / or a platelet count less than 120×10/*** measured plasma copeptin levels on admission using an enzyme-linked immunosorbent assay in a blinded *** multivariate logistic regression analysis,plasma copeptin level emerged as an independent predictor of progressive hemorrhagic injury and acute traumatic *** receiver operating characteristic curves,we calculated areas under the curve for progressive hemorrhagic injury and acute traumatic *** predictive performance of copeptin was similar to that of Glasgow Coma Scale ***,copeptin did not obviously improve the predictive value of Glasgow Coma Scale ***,copeptin may help in the prediction of progressive hemorrhagic injury and acute traumatic coagulopathy after traumatic brain injury.

关键词： Copeptin Traumatic brain injury Acute traumatic coagulopathy progressive hemorrhagic injury Biomarker

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Plasma soluble CD40 ligand level predicts acute traumatic coagulopathy, progressive hemorrhagic injury and posttraumatic cerebral infarction after traumatic brain injury

Plasma soluble CD40 ligand level predicts acute traumatic co...

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2015浙江省神经外科学学术年会暨浙闽江赣四省神经外科学术交流会

作者：董晓巧俞文华杜权朱强王昊车志豪杨定博沈永锋江力刘群杰杭州市第一人民医院神经外科

Abstract Background:Acute traumatic coagulopathy(ATC),progressive hemorrhagic injury(PHI)and posttraumatic cerebral infarction(PTCI)have high prevalence and are strong predictors of mortality after severe traumatic brain injury(STBI).Circulating soluble CD40 ligand(s CD40L)levels are associated with severity and clinical outcome of some critical *** present study is designed to investigate the relationship between plasma s CD40L levels,ATC,PHI and PTCI following ***:112 STBI patients were *** of PHI and PTCI was made on the follow-up computerized tomography *** was defined based on coagulation *** s CD40L levels on admission were ***:In multivariate logistic regression analysis,plasma s CD40L level emerged as an independent predictor of PHI,ACT and *** under receiver operating characteristic curve of plasma s CD40L level was similar to that of Glasgow Coma Scalescore for prediction of PHI,ACT and ***:It is suggested that plasma s CD40L level may represent a novel biomarker for predicting PHI,ACT and PTCI after STBI.

关键词： Traumatic brain injury soluble CD40 ligand Acute traumatic coagulopathy progressive hemorrhagic injury Posttraumatic cerebral infarction

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Disseminated intravascular coagulation scores as predictors for progressive hemorrhage and neurological prognosis following traumatic brain injury

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Neural Regeneration Research 2011年第2期6卷 136-142页

作者： Yirui Sun Caihua Xi Ersong Wang Jianqing Wang Yong Liu Hua Liu Qiang Yuan Haijun Yao Liangfu Zhou Jin Hu Department of Neurosurgery Huashan Hospital Fudan University Shanghai 200040 China Shanghai Sixth Hospital Shanghai Jiao Tong University Shanghai 200233 China Department of Neurosurgery Ruijin Minhang District Central Hospital Shanghai 201100 China Nanjing Brain Hospital Nanjing Medical University Nanjing 100027 Jiangsu Province China

Coagulation abnormalities, such as disseminated intravascular coagulation （DIC）, are associated with progressive hemcrrhagic injury （PHI） following head trauma. However, the exact relationship between coagulopathy and PHI remains unclear. The present study utilized a scoring system defined by the International Society of Thrombosis and Haemostasis to investigate whether a high DIC score is predictive for PHI. This study was a multicenter prospective design involving four hospitals, a 6-month observation, and follow-up. Of 352 traumatic brain injury （TBI） patients, serial CT scan indicated approximately one third of patients developed progressive hemorrhage, which was most frequently observed in the frontal, temporal, and orbitofrontal lobes of patients with brain contusion. PHI-positive patients exhibited poor prognosis, as indicated by prolonged length of hospital/intensive care unit stay and high mortality. More importantly, a DIC score after TBI, as well as patient age and sex, could serve as predictors for PHI. In addition, DIC scores were closely associated with injury severity. Therefore, the DIC scoring system facilitated early PHI diagnosis in TBI patients, and DIC scores might serve as a valuable predictor for TBI patients with PHI.

关键词： coagulopathy disseminated intravascular coagulation disseminated intravascular coagulation scoring intracranial hemorrhage progressive hemorrhagic injury traumatic brain injury

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