血清瓜氨酸评估严重创伤后早期急性胃肠损伤的临床价值

doi:10.3969/j.issn.1002-1949.2017.11.012

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (11): 1020-1024 DOI: 10.3969/j.issn.1002-1949.2017.11.012

The value of serum citrulline in predicting the early acute gastrointestinal injury after severe trauma

Wang Rui, Li Pei-jie, Yin Lu-lu, Su Cheng-yang, Zhang Zhi-cang

Department of Critical Care Medicine, the Second Hospital of Lanzhou University,Lanzhou 730030,China

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Abstract Objective: To investigate the serum clinical significance of serumcitrulline level in predicting the early acute gastrointestinal injury and organ failure by measuring the level of citrulline at different time points in patients with severe trauma. Methods: The 72 patients after severe trauma in MICU of the Second Hospital of Lanzhou University were studied prospectively from August 2015 to December 2016.The patients were divided into mild trauma group (ISS <16) and severe trauma group (ISS ≥ 16) according to trauma severity score ISS,and divided into four groups, AGI 0 group, AGI 1 group, AGI 2 group, AGI 3 group according to the 2012 European Critical Care Medicine Association (ESICM) AGI classification guidelines.We selected the people for health examination as a normal control group.The basic clinical data and the grade of AGI were collected.The levels of serumcitrulline were measured by high performance liquid chromatography on day 1 and day 3. Results: Compared to the normal control group,the serum citrulline levels in the minor trauma group and the severe trauma group were both reduced obviously after trauma(P＜0.01 or P＜0.05),with lower level in the severe traumatic group than that in the minor trauma group(P＜0.01).The serum citrulline levels in both group decreased gradually at day 3(P＜0.01).The higher grade of AGI,the lower the level of serum citrulline(P＜0.01 or P＜0.05),each group of citrulline levels were further reduced at day 3(P＜0.01).The level of serum citrulline was negatively correlated with AGI severity,SOFA score and APACHEⅡscore.Citrulline≤19.07 μmol/L is the best value of predicting AGI after severe trauma. Conlusion: The decreased serum citrulline in patients with severe trauma is closely related to the severity of trauma and has a certain clinical value in predicting early AGI and MODS.

Received: 05 March 2017

Corresponding Authors: Li Pei-jie, E-mail:lipeijielanzhou@hotmail.com

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Wang Rui,Li Pei-jie,Yin Lu-lu, et al. The value of serum citrulline in predicting the early acute gastrointestinal injury after severe trauma[J]. Chinese Journal of Critical Care Medicine, 2017, 37(11): 1020-1024.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.11.012 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I11/1020

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