首页 期刊 论文 学科刊群 资讯 加盟 关于
EN
image
Article(id=1211269163348259378, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2021.04.08, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1592236800000, receivedDateStr=2020-06-16, revisedDate=1612368000000, revisedDateStr=2021-02-04, acceptedDate=null, acceptedDateStr=null, onlineDate=1766718672834, onlineDateStr=2025-12-26, pubDate=1619539200000, pubDateStr=2021-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766718672834, onlineIssueDateStr=2025-12-26, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766718672834, creator=13701087609, updateTime=1766718672834, updator=13701087609, issue=Issue{id=1211269157790806494, tenantId=1146029695717560320, journalId=1189873630562394117, year='2021', volume='46', issue='4', pageStart='319', pageEnd='424', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1766718671510, creator=13701087609, updateTime=1766718756000, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1211269512217882745, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1211269512217882746, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=367, endPage=372, ext={EN=ArticleExt(id=1211269163729941052, articleId=1211269163348259378, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Analysis of warning indicators of coagulopathy related to traumatic lung injury and its clinical value, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To study the warning indicators and clinical value of coagulopathy related to traumatic lung injury(TLI). Methods The data of 159 patients with TLI from September 2015 to November 2019 in the intensive care unit of the 908th Hospital of Chinese PLA Logistical Support Force were analyzed retrospectively, including their hemoglobin (HGB), platelet (PLT), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), D-dimer (D-D), antithrombin Ⅲ (AT-Ⅲ), fibrin degradation product (FDP) and thromboelastography.According to the 90-d prognosis of patients with TLI, they were divided into survival group (n=141) and death group (n=18). COX regression analysis and ROC curve analysis were carried out, and the risk factors INR were screened out. The patients were divided into INR≥1.36 group (n=49) and INR<1.36 group (n=110) for analysis. Results In survival group, INR, lactate (Lac), and injury severe score (ISS) score were significantly lower than those in death group (Z=–4.493, –3.481, –3.177, P<0.01); APTT, PT, R time and K time were much shorter than death group (Z=–3.275, –4.325, –3.300, –2.278, P<0.01); Oxygenation index, PLT, HGB, AT-Ⅲ, blood clots maximum intensity (MA), blood clot formation dynamics (Angle) and coagulation index (CI) were significantly better than those in death group (Z/t=–4.053, –2.764, 0.269, –2.159, –3.058, –3.294, –3.016, P<0.01). Cox regression analysis showed that INR (RR=2.18, 95%CI 1.07-4.43, P=0.031) were significantly correlated with the death of TLI patients. ROC curve analysis showed that the area under the curve for INR to judge the death of TLI patients was 0.826 (P<0.0001), the cut-off value was 1.36 (P<0.0001)and the sensitivity and specificity were 0.788 and 0.752, respectively. The survival rate in INR<1.36 group was significantly higher than that in INR≥1.36 group (P<0.0001). Compared with INR<1.36 group, in INR≥1.36 group, the Lac and ISS score significantly increased (P<0.05); APTT, PT and K time significantly prolonged (P<0.05); the oxygenation index, PLT, HGB, AT-Ⅲ, MA, Angle and CI decreased significantly (P<0.05). Conclusions TLI patients with INR≥1.36 can be used as an early warning indicator of TLI-related coagulopathy, and the risk of death of TLI related coagulation disease patients is significantly increased.

, correspAuthors=Jing-Chun Song, authorNote=null, correspAuthorsNote=
*E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Qing-Wei Lin, Jing-Chun Song, Ting Yu, Jun-Jie Zeng, Yang Wu, Hui-Qiang Liu, Lin-Cui Zhong), CN=ArticleExt(id=1211269164732379744, articleId=1211269163348259378, tenantId=1146029695717560320, journalId=1189873630562394117, language=CN, title=创伤性肺损伤相关凝血病的预警指标及其临床价值分析, columnId=1190310109164180259, journalTitle=解放军医学杂志, columnName=临床研究, runingTitle=null, highlight=null, articleAbstract=

目的 探讨创伤性肺损伤(TLI)相关凝血病的预警指标及其临床价值。方法 回顾性分析2015年9月—2019年11月解放军联勤保障部队第908医院重症医学科收治的159例TLI患者的基础资料及入科时的血红蛋白(HGB)、血小板计数(PLT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶时间(TT)、D-二聚体(D-D)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白降解产物(FDP)和血栓弹力图(TEG)参数。依据TLI患者90 d预后分为生存组(n=141)与死亡组(n=18)，采用多因素Cox回归分析和ROC曲线分析筛选出危险因素INR，并根据INR截断值分为INR≥1.36组(n=49)与INR<1.36组(n=110)，进行组间比较及生存分析。结果 生存组INR、乳酸(Lac)、创伤严重程度(ISS)评分明显低于死亡组(Z=–4.493、–3.481、–3.177，P<0.01)，APTT、PT、R时间、K时间明显短于死亡组(Z=–3.275、–4.325、–3.300、–2.278，P<0.01)，氧合指数、PLT、HGB、AT-Ⅲ、血块最大强度(MA)、血块形成动力学(Angle)、凝血综合指数(CI)明显高于死亡组(Z/t=–4.053、–2.764、0.269、–2.159、–3.058、–3.294、–3.016，P<0.01)。多因素Cox回归分析结果显示，INR与TLI患者死亡明显相关(RR=4.882，95%CI 1.263~18.870，P=0.022)。ROC曲线分析结果显示，INR判断TLI患者死亡的曲线下面积(AUC)为0.826(P<0.0001)，敏感度为0.788，特异度为0.752，截断值为1.36。INR<1.36组生存率明显高于INR≥1.36组(P<0.0001)。与INR<1.36组比较，INR≥1.36组Lac、ISS评分均明显升高(P<0.05)，APTT、PT、K时间均明显延长(P<0.05)，氧合指数、PLT、HGB、AT-Ⅲ、MA、Angle、CI均明显降低(P<0.05)。结论 INR≥1.36可作为TLI相关凝血病发生的预警指标，TLI相关凝血病患者的死亡风险明显增加。

, correspAuthors=宋景春, authorNote=null, correspAuthorsNote=
宋景春，E-mail：
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=0xOm68syc+rT3DaNiaYTSQ==, magXml=flFSD+VyL2fFXLqmPqoWpg==, pdfUrl=null, pdf=YXYixo92vvmqXznGTNWIzw==, pdfFileSize=928454, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=6uGVyVJ2H5RcpLVktbZAow==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=sieYB+5M6mnQBCE75PX50w==, mapNumber=null, authorCompany=null, fund=null, authors=

林青伟，硕士研究生，主要从事弥散性血管内凝血中西医结合治疗方面的研究

, authorsList=林青伟, 宋景春, 余婷, 曾俊杰, 吴阳, 刘慧强, 钟林翠)}, authors=[Author(id=1211269165105672830, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269165214724743, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269165105672830, language=EN, stringName=Qing-Wei Lin, firstName=Qing-Wei, middleName=null, lastName=Lin, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269165495743115, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269165105672830, language=CN, stringName=林青伟, firstName=青伟, middleName=null, lastName=林, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio={"content":"

林青伟，硕士研究生，主要从事弥散性血管内凝血中西医结合治疗方面的研究

"}, bioImg=null, bioContent=

林青伟，硕士研究生，主要从事弥散性血管内凝血中西医结合治疗方面的研究

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269166716285587, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=songjingchun@126.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1211269166816948888, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269166716285587, language=EN, stringName=Jing-Chun Song, firstName=Jing-Chun, middleName=null, lastName=Song, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269166917612191, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269166716285587, language=CN, stringName=宋景春, firstName=景春, middleName=null, lastName=宋, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269167035052708, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269167127327402, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167035052708, language=EN, stringName=Ting Yu, firstName=Ting, middleName=null, lastName=Yu, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269167227990705, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167035052708, language=CN, stringName=余婷, firstName=婷, middleName=null, lastName=余, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269167332848309, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269167437705921, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167332848309, language=EN, stringName=Jun-Jie Zeng, firstName=Jun-Jie, middleName=null, lastName=Zeng, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269167542563528, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167332848309, language=CN, stringName=曾俊杰, firstName=俊杰, middleName=null, lastName=曾, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269167651615441, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269167739695830, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167651615441, language=EN, stringName=Yang Wu, firstName=Yang, middleName=null, lastName=Wu, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269167840359134, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167651615441, language=CN, stringName=吴阳, firstName=阳, middleName=null, lastName=吴, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269167945216744, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=5, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269168058462961, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167945216744, language=EN, stringName=Hui-Qiang Liu, firstName=Hui-Qiang, middleName=null, lastName=Liu, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269168138154744, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269167945216744, language=CN, stringName=刘慧强, firstName=慧强, middleName=null, lastName=刘, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])]), Author(id=1211269168263983868, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, orderNo=6, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1211269168377230084, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269168263983868, language=EN, stringName=Lin-Cui Zhong, firstName=Lin-Cui, middleName=null, lastName=Zhong, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1211269168461116170, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, authorId=1211269168263983868, language=CN, stringName=钟林翠, firstName=林翠, middleName=null, lastName=钟, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=解放军联勤保障部队第908医院重症医学科，南昌 330002, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])])], keywords=[Keyword(id=1211269168578556687, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, orderNo=1, keyword=trauma), Keyword(id=1211269168700191510, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, orderNo=2, keyword=lung injury), Keyword(id=1211269168960238364, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, orderNo=3, keyword=coagulation disease), Keyword(id=1211269169102844707, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, orderNo=4, keyword=international standardized rate), Keyword(id=1211269169279005482, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, orderNo=1, keyword=创伤), Keyword(id=1211269169383863090, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, orderNo=2, keyword=肺损伤), Keyword(id=1211269169513886522, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, orderNo=3, keyword=凝血病), Keyword(id=1211269169585189695, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, orderNo=4, keyword=国际标准化比值)], refs=[Reference(id=1211269173070656456, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2020, volume=72, issue=4, pageStart=547, pageEnd=553, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=Homo RL, Grigorian A, Lekawa M, journalName=Updates Surg, refType=null, unstructuredReference=Homo RL, Grigorian A, Lekawa M, et al. Outcomes after pneumonectomy versus limited lung resection in adults with traumatic lung injury[J]. Updates Surg, 2020, 72(4): 547-553., articleTitle=Outcomes after pneumonectomy versus limited lung resection in adults with traumatic lung injury, refAbstract=null), Reference(id=1211269173141959630, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2017, volume=97, issue=4, pageStart=783, pageEnd=799, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=Platz JJ, Loic F, Norotsky M, journalName=Surg Clin North Am, refType=null, unstructuredReference=Platz JJ, Loic F, Norotsky M, et al. Thoracic trauma: injuries, evaluation, and treatment[J]. Surg Clin North Am, 2017, 97(4): 783-799., articleTitle=Thoracic trauma: injuries, evaluation, and treatment, refAbstract=null), Reference(id=1211269173246817233, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2017, volume=48, issue=11, pageStart=2400, pageEnd=2406, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Störmann P, Lustenberger T, Relja B, journalName=Injury, refType=null, unstructuredReference=Störmann P, Lustenberger T, Relja B, et al. Role of biomarkers in acute traumatic lung injury[J]. Injury, 2017, 48(11): 2400-2406., articleTitle=Role of biomarkers in acute traumatic lung injury, refAbstract=null), Reference(id=1211269173330703316, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2007, volume=35, issue=10, pageStart=2243, pageEnd=2250, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Calfee CS, Eisner MD, Ware LB, journalName=Crit Care Med, refType=null, unstructuredReference=Calfee CS, Eisner MD, Ware LB, et al. Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders[J]. Crit Care Med, 2007, 35(10): 2243-2250., articleTitle=Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders, refAbstract=null), Reference(id=1211269173410395094, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2019, volume=23, issue=1, pageStart=98, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=Spahn DR, Bouillon B, Cerny V, journalName=Crit Care, refType=null, unstructuredReference=Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition[J]. Crit Care, 2019, 23(1): 98., articleTitle=The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition, refAbstract=null), Reference(id=1211269173469115353, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2020, volume=45, issue=11, pageStart=1144, pageEnd=1150, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=Tang LQ, Zhang XQ, Tong HS, journalName=Med J Chin PLA, refType=null, unstructuredReference=Tang LQ, Zhang XQ, Tong HS, et al. The effect of serum HMGB1 levels on the severity and prognosis of critical ill patients with early trauma-induced coagulopathy in the intensive care unit[J]. Med J Chin PLA, 2020, 45(11): 1144-1150., articleTitle=The effect of serum HMGB1 levels on the severity and prognosis of critical ill patients with early trauma-induced coagulopathy in the intensive care unit, refAbstract=null), Reference(id=1211269173553001437, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2020, volume=45, issue=11, pageStart=1144, pageEnd=1150, url=null, language=null, rfNumber=[6], rfOrder=6, authorNames=唐丽群, 张兴钦, 童华生, journalName=解放军医学杂志, refType=null, unstructuredReference=[唐丽群, 张兴钦, 童华生, 等. 血清HMGB1水平对创伤性凝血病早期危重患者病情及预后的影响[J]. 解放军医学杂志, 2020, 45(11): 1144-1150.], articleTitle=血清HMGB1水平对创伤性凝血病早期危重患者病情及预后的影响, refAbstract=null), Reference(id=1211269173620110305, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2013, volume=17, issue=5, pageStart=R253, pageEnd=null, url=null, language=null, rfNumber=[7], rfOrder=7, authorNames=Ware LB, Koyama T, Zhao Z, journalName=Crit Care, refType=null, unstructuredReference=Ware LB, Koyama T, Zhao Z, et al. Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome[J]. Crit Care, 2013, 17(5): R253., articleTitle=Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome, refAbstract=null), Reference(id=1211269173703996388, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2014, volume=76, issue=3, pageStart=601, pageEnd=608, url=null, language=null, rfNumber=[8], rfOrder=8, authorNames=Hoth JJ, Wells JD, Jones SE, journalName=J Trauma Acute Care Surg, refType=null, unstructuredReference=Hoth JJ, Wells JD, Jones SE, et al. Complement mediates a primed inflammatory response after traumatic lung injury[J]. J Trauma Acute Care Surg, 2014, 76(3): 601-608., articleTitle=Complement mediates a primed inflammatory response after traumatic lung injury, refAbstract=null), Reference(id=1211269173792076776, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2017, volume=23, issue=6, pageStart=503, pageEnd=510, url=null, language=null, rfNumber=[9], rfOrder=9, authorNames=Stensballe J, Henriksen HH, Johansson PI, journalName=Curr Opin Crit Care, refType=null, unstructuredReference=Stensballe J, Henriksen HH, Johansson PI. Early haemorrhage control and management of trauma-induced coagulopathy: the importance of goal-directed therapy[J]. Curr Opin Crit Care, 2017, 23(6): 503-510., articleTitle=Early haemorrhage control and management of trauma-induced coagulopathy: the importance of goal-directed therapy, refAbstract=null), Reference(id=1211269173896934378, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2014, volume=24, issue=1, pageStart=63, pageEnd=74, url=null, language=null, rfNumber=[10], rfOrder=10, authorNames=Palmer L, Martin L, journalName=J Vet Emerg Crit Care (San Antonio), refType=null, unstructuredReference=Palmer L, Martin L. Traumatic coagulopathy-Part 1: Pathophysiology and diagnosis[J]. J Vet Emerg Crit Care (San Antonio), 2014, 24(1): 63-74., articleTitle=Traumatic coagulopathy-Part 1: Pathophysiology and diagnosis, refAbstract=null), Reference(id=1211269173997597678, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2019, volume=116, issue=47, pageStart=799, pageEnd=806, url=null, language=null, rfNumber=[11], rfOrder=11, authorNames=Maegele M, journalName=Dtsch Arztebl Int, refType=null, unstructuredReference=Maegele M. The diagnosis and treatment of acute traumatic bleeding and coagulopathy[J]. Dtsch Arztebl Int, 2019, 116(47): 799-806., articleTitle=The diagnosis and treatment of acute traumatic bleeding and coagulopathy, refAbstract=null), Reference(id=1211269174085678065, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2019, volume=12, issue=2, pageStart=145, pageEnd=149, url=null, language=null, rfNumber=[12], rfOrder=12, authorNames=Maduka AKI, Lin GJ, Lim WW, journalName=J Emerg Trauma Shock, refType=null, unstructuredReference=Maduka AKI, Lin GJ, Lim WW, et al. A comprehensive analysis of traumatic rib fractures in an Acute General Hospital in Singapore[J]. J Emerg Trauma Shock, 2019, 12(2): 145-149., articleTitle=A comprehensive analysis of traumatic rib fractures in an Acute General Hospital in Singapore, refAbstract=null), Reference(id=1211269174177952757, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2019, volume=39, issue=1, pageStart=20, pageEnd=27, url=null, language=null, rfNumber=[13], rfOrder=13, authorNames=Petros S, journalName=Hamostaseologie, refType=null, unstructuredReference=Petros S. Trauma-induced coagulopathy[J]. Hamostaseologie, 2019, 39(1): 20-27., articleTitle=Trauma-induced coagulopathy, refAbstract=null), Reference(id=1211269174240867319, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2018, volume=34, issue=1, pageStart=32, pageEnd=39, url=null, language=null, rfNumber=[14], rfOrder=14, authorNames=Liu W, Cai JK, journalName=Chin J Burns, refType=null, unstructuredReference=Liu W, Cai JK. Influences of ulinastatin on acute lung injury and time phase changes of coagulation parameters in rats with burn-blast combined injuries[J]. Chin J Burns, 2018, 34(1): 32-39., articleTitle=Influences of ulinastatin on acute lung injury and time phase changes of coagulation parameters in rats with burn-blast combined injuries, refAbstract=null), Reference(id=1211269174316364794, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2018, volume=34, issue=1, pageStart=32, pageEnd=39, url=null, language=null, rfNumber=[14], rfOrder=15, authorNames=刘伟, 柴家科, journalName=中华烧伤杂志, refType=null, unstructuredReference=[刘伟, 柴家科. 乌司他丁对烧冲复合伤大鼠急性肺损伤及凝血参数时相性变化的影响[J]. 中华烧伤杂志, 2018, 34(1): 32-39.], articleTitle=乌司他丁对烧冲复合伤大鼠急性肺损伤及凝血参数时相性变化的影响, refAbstract=null), Reference(id=1211269174387667965, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2020, volume=79, issue=null, pageStart=106175, pageEnd=null, url=null, language=null, rfNumber=[15], rfOrder=16, authorNames=Shao XF, Li B, Shen J, journalName=Int Immunopharmacol, refType=null, unstructuredReference=Shao XF, Li B, Shen J, et al. Ghrelin alleviates traumatic brain injury-induced acute lung injury through pyroptosis/NF-κB pathway[J]. Int Immunopharmacol, 2020, 79: 106175., articleTitle=Ghrelin alleviates traumatic brain injury-induced acute lung injury through pyroptosis/NF-κB pathway, refAbstract=null), Reference(id=1211269174484136961, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2019, volume=14, issue=null, pageStart=36, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=17, authorNames=Halát G, Haider T, Dedeyan M, journalName=World J Emerg Surg, refType=null, unstructuredReference=Halát G, Haider T, Dedeyan M, et al. IL-33 and its increased serum levels as an alarmin for imminent pulmonary complications in polytraumatized patients[J]. World J Emerg Surg, 2019, 14: 36., articleTitle=IL-33 and its increased serum levels as an alarmin for imminent pulmonary complications in polytraumatized patients, refAbstract=null), Reference(id=1211269174555439106, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, doi=null, pmid=null, pmcid=null, year=2018, volume=22, issue=5, pageStart=1402, pageEnd=1408, url=null, language=null, rfNumber=[17], rfOrder=18, authorNames=Hu LY, Cui JB, Xu XM, journalName=Eur Rev Med Pharmacol Sci, refType=null, unstructuredReference=Hu LY, Cui JB, Xu XM, et al. Expression of Nrf2-Keap1-ARE signal pathway in traumatic lung injury and functional study[J]. Eur Rev Med Pharmacol Sci, 2018, 22(5): 1402-1408., articleTitle=Expression of Nrf2-Keap1-ARE signal pathway in traumatic lung injury and functional study, refAbstract=null)], funds=[Fund(id=1211269172756083640, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, awardId=20204818, language=EN, fundingSource=Science and Technology Plan of Jiangxi Provincial Health Commission(20204818), fundOrder=null, country=null), Fund(id=1211269172835775422, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, awardId=20204818, language=CN, fundingSource=江西省卫健委科技计划(20204818), fundOrder=null, country=null), Fund(id=1211269172894495679, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, awardId=20195684, language=EN, fundingSource=Science and Technology Plan of Jiangxi Provincial Health Commission(20195684), fundOrder=null, country=null), Fund(id=1211269172965798852, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, awardId=20195684, language=CN, fundingSource=江西省卫健委科技计划(20195684), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1211269165025981044, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, xref=null, ext=[AuthorCompanyExt(id=1211269165034369653, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China), AuthorCompanyExt(id=1211269165038563958, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, companyId=1211269165025981044, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=解放军联勤保障部队第908医院重症医学科，南昌 330002)])], figs=[ArticleFig(id=1211269169706824517, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Fig.1, caption=ROC curve of INR in predicting the prognosis of TLI patients, figureFileSmall=ZoJnxw1E6R8c5YHrs/Neug==, figureFileBig=6uGVyVJ2H5RcpLVktbZAow==, tableContent=null), ArticleFig(id=1211269169832653645, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=图1, caption=INR判断TLI患者预后的ROC曲线分析

INR. 国际标准化比值；TLI. 创伤性肺损伤

, figureFileSmall=ZoJnxw1E6R8c5YHrs/Neug==, figureFileBig=6uGVyVJ2H5RcpLVktbZAow==, tableContent=null), ArticleFig(id=1211269170717651804, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Fig.2, caption=Kaplan-Meier graph for TLI patients, figureFileSmall=97I0SKJxoN1FQHJPwtZKsA==, figureFileBig=KeJZ6r6bE6KsKtuU+VY6fQ==, tableContent=null), ArticleFig(id=1211269170864452447, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=图2, caption=创伤性肺损伤患者生存曲线

INR. 国际标准化比值；TLI. 创伤性肺损伤

, figureFileSmall=97I0SKJxoN1FQHJPwtZKsA==, figureFileBig=KeJZ6r6bE6KsKtuU+VY6fQ==, tableContent=null), ArticleFig(id=1211269170981892967, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.1, caption=

Comparison of demographic data between TLI patients in survival and death group

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)F/Z/χ2P
年龄(岁，$\bar{x}±s$)48.8±17.347.0±19.40.7270.707
性别[例(%)]  2.4760.116
 男116(82.3)12(66.7)
 女25(17.7)6(33.3)
致伤原因[例(%)]  0.0190.890
 钝132(93.6)17(94.4)
 锐9(6.4)1(5.6)
机械通气[例(%)]  4.0700.044
 是78(55.3)15(83.3)
 否63(44.7)3(16.7)
合并损伤[例(%)]
 脑外伤9(6.4)2(11.1)0.0730.788
 腹部外伤74(52.5)10(55.6)0.0600.806
 骨盆损伤28(19.9)4(22.2)0.0550.814
 四肢外伤80(56.7)10(55.60.0090.924
氧合指数[mmHg，M(Q1，Q3)]280(180，340)138(63，218)–4.0530.000
ISS评分[分，M(Q1，Q3)]24(19，29)29(25，35)–3.1770.001
Lac水平[mmol/L，M(Q1，Q3)]2.4(1.4，3.8)5.3(3.5，11.2)–3.4810.001
HGB (g/L，$\bar{x}±s$)99.0±25.974.3±26.70.2690.000
ICU住院时间[d，M(Q1，Q3)]13.0(8.0，24.0)3.5(1.0，18.9)–3.1660.002
), ArticleFig(id=1211269171086750572, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表1, caption=

创伤性肺损伤生存组与死亡组患者基础资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)F/Z/χ2P
年龄(岁，$\bar{x}±s$)48.8±17.347.0±19.40.7270.707
性别[例(%)]  2.4760.116
 男116(82.3)12(66.7)
 女25(17.7)6(33.3)
致伤原因[例(%)]  0.0190.890
 钝132(93.6)17(94.4)
 锐9(6.4)1(5.6)
机械通气[例(%)]  4.0700.044
 是78(55.3)15(83.3)
 否63(44.7)3(16.7)
合并损伤[例(%)]
 脑外伤9(6.4)2(11.1)0.0730.788
 腹部外伤74(52.5)10(55.6)0.0600.806
 骨盆损伤28(19.9)4(22.2)0.0550.814
 四肢外伤80(56.7)10(55.60.0090.924
氧合指数[mmHg，M(Q1，Q3)]280(180，340)138(63，218)–4.0530.000
ISS评分[分，M(Q1，Q3)]24(19，29)29(25，35)–3.1770.001
Lac水平[mmol/L，M(Q1，Q3)]2.4(1.4，3.8)5.3(3.5，11.2)–3.4810.001
HGB (g/L，$\bar{x}±s$)99.0±25.974.3±26.70.2690.000
ICU住院时间[d，M(Q1，Q3)]13.0(8.0，24.0)3.5(1.0，18.9)–3.1660.002
), ArticleFig(id=1211269171220968303, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.2, caption=

Comparison of routine coagulation parameters between TLI patients in survival and death group [M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)ZP
PLT (×109/L)85(114，167)65(33，135)–2.7640.006
FIB (g/L)1.91(1.45，3.27)1.21(0.56，2.98)–2.1770.029
APTT (s)32.3(27.7，40.4)41.6(36.7，63.4)–3.2750.001
PT (s)15.0(12.7，17.0)20.9(16.2，33.9)–4.3250.000
INR1.22(1.03，1.36)1.70(1.34，2.72)–4.4930.000
TT (s)14.0(12.1，17.0)15.9(12.9，23.8)–1.7500.080
D-D (μg/ml)7.9(3.9，21.5)11.9(4.3，27.0)–0.4690.639
FDP (μg/ml)34.8(13.6，72.9)50.1(25.9，93.4)–1.0390.299
AT-Ⅲ(%)64.0(51.1，82.4)54.8(45.8，63.0)–2.1590.031
), ArticleFig(id=1211269171380351862, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表2, caption=

创伤性肺损伤生存组与死亡组患者常规凝血项目比较[M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)ZP
PLT (×109/L)85(114，167)65(33，135)–2.7640.006
FIB (g/L)1.91(1.45，3.27)1.21(0.56，2.98)–2.1770.029
APTT (s)32.3(27.7，40.4)41.6(36.7，63.4)–3.2750.001
PT (s)15.0(12.7，17.0)20.9(16.2，33.9)–4.3250.000
INR1.22(1.03，1.36)1.70(1.34，2.72)–4.4930.000
TT (s)14.0(12.1，17.0)15.9(12.9，23.8)–1.7500.080
D-D (μg/ml)7.9(3.9，21.5)11.9(4.3，27.0)–0.4690.639
FDP (μg/ml)34.8(13.6，72.9)50.1(25.9，93.4)–1.0390.299
AT-Ⅲ(%)64.0(51.1，82.4)54.8(45.8，63.0)–2.1590.031
), ArticleFig(id=1211269171539735423, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.3, caption=

Comparison of TEG parameters between TLI patients in survival and death group [M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)ZP
R (min)6.9(5.5，8.5)9.6(7.1，17.4)–3.3000.001
K (min)2.8(2.0，4.2)4.3(2.5，11.3)–2.2780.023
Angle (°)54.3(41.4，61.4)31.8(17.7，49.9)–3.2940.001
MA (mm)51(43.4，59.1)35.7(25.5，47.5)–3.0580.002
CI–2.6(–5.7，–0.8)–6.5(–12.1，–3.1)–3.0160.003
), ArticleFig(id=1211269171665564545, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表3, caption=

创伤性肺损伤生存组与死亡组患者TEG参数比较[M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目生存组(n=141)死亡组(n=18)ZP
R (min)6.9(5.5，8.5)9.6(7.1，17.4)–3.3000.001
K (min)2.8(2.0，4.2)4.3(2.5，11.3)–2.2780.023
Angle (°)54.3(41.4，61.4)31.8(17.7，49.9)–3.2940.001
MA (mm)51(43.4，59.1)35.7(25.5，47.5)–3.0580.002
CI–2.6(–5.7，–0.8)–6.5(–12.1，–3.1)–3.0160.003
), ArticleFig(id=1211269171762033543, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.4, caption=

Multivariate Cox regression analysis of the prognostic factors for TLI patients

, figureFileSmall=null, figureFileBig=null, tableContent=
变量RR95%CIP
年龄1.0000.973~1.0270.977
性别(男/女)0.4920.184~1.3170.158
致伤原因(钝/锐)1.1240.149~8.4570.910
氧合指数0.9950.988~1.0010.111
ISS评分1.0730.995~1.1560.067
Lac0.7910.529~1.1820.253
PLT0.9940.985~1.0040.274
HGB0.2870.937~1.0200.287
R0.6040.287~1.2710.184
K0.7940.508~1.2420.312
Angle1.1240.953~1.3250.165
MA1.0370.972~1.1070.269
CI0.9030.802~1.0170.093
APTT0.9390.936~1.0280.173
PT0.4750.197~1.1410.096
TT1.0320.831~1.2800.777
FIB0.7520.513~1.1010.142
D-D0.9920.968~1.0160.511
FDP0.9990.992~1.0060.756
AT-Ⅲ1.0000.999~1.0010.740
INR4.8821.263~18.8700.022
), ArticleFig(id=1211269171871085455, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表4, caption=

创伤性肺损伤患者预后影响因素的多因素Cox回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量RR95%CIP
年龄1.0000.973~1.0270.977
性别(男/女)0.4920.184~1.3170.158
致伤原因(钝/锐)1.1240.149~8.4570.910
氧合指数0.9950.988~1.0010.111
ISS评分1.0730.995~1.1560.067
Lac0.7910.529~1.1820.253
PLT0.9940.985~1.0040.274
HGB0.2870.937~1.0200.287
R0.6040.287~1.2710.184
K0.7940.508~1.2420.312
Angle1.1240.953~1.3250.165
MA1.0370.972~1.1070.269
CI0.9030.802~1.0170.093
APTT0.9390.936~1.0280.173
PT0.4750.197~1.1410.096
TT1.0320.831~1.2800.777
FIB0.7520.513~1.1010.142
D-D0.9920.968~1.0160.511
FDP0.9990.992~1.0060.756
AT-Ⅲ1.0000.999~1.0010.740
INR4.8821.263~18.8700.022
), ArticleFig(id=1211269171963360147, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.5, caption=

Demographic data of TLI patients in INR≥1.36 group and INR<1.36 group

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)F/Z/χ2P
年龄(岁，$\bar{x}±s$)45.8±18.349.9±17.10.5200.177
性别[例(%)]  2.2330.135
 男36(73.5)92(83.6)
 女13(26.5)18(16.4)
致伤原因[例(%)]  0.4220.516
 钝45(91.8)104(94.5)
 锐4(8.2)6(5.5)
氧合指数[mmHg，M(Q1，Q3)]217(147，315)265(180，340)–1.9740.048
机械通气[例(%)]  4.8830.027
 是34(69.4)58(52.7)
 否14(28.6)52(47.3)
ISS评分[分，M(Q1，Q3)]27(22，34)24(19，29)–2.1410.032
Lac水平[mmol/L，M(Q1，Q3)]4.9(2.6，9.2)2.1(1.2，3.6)–5.5020.000
HGB (g/L，$\bar{x}±s$)88.8±31.299.5±24.32.8990.021
ICU住院时间[d，M(Q1，Q3)]11(6，24)13(8，23)–0.7410.459
死亡[例(%)]14(28.6)4(3.6)20.9950.000
), ArticleFig(id=1211269172097577882, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表5, caption=

创伤性肺损伤INR≥1.36组与INR<1.36组患者基础资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)F/Z/χ2P
年龄(岁，$\bar{x}±s$)45.8±18.349.9±17.10.5200.177
性别[例(%)]  2.2330.135
 男36(73.5)92(83.6)
 女13(26.5)18(16.4)
致伤原因[例(%)]  0.4220.516
 钝45(91.8)104(94.5)
 锐4(8.2)6(5.5)
氧合指数[mmHg，M(Q1，Q3)]217(147，315)265(180，340)–1.9740.048
机械通气[例(%)]  4.8830.027
 是34(69.4)58(52.7)
 否14(28.6)52(47.3)
ISS评分[分，M(Q1，Q3)]27(22，34)24(19，29)–2.1410.032
Lac水平[mmol/L，M(Q1，Q3)]4.9(2.6，9.2)2.1(1.2，3.6)–5.5020.000
HGB (g/L，$\bar{x}±s$)88.8±31.299.5±24.32.8990.021
ICU住院时间[d，M(Q1，Q3)]11(6，24)13(8，23)–0.7410.459
死亡[例(%)]14(28.6)4(3.6)20.9950.000
), ArticleFig(id=1211269172181463965, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.6, caption=

Comparison of routine coagulation parameters between two groups of TLI patients [M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)ZP
PLT (×109/L)97(55，126)123(86，172)–3.3540.001
FIB (g/L)1.19(0.77，1.90)2.20(1.58，3.53)–4.6680.000
APTT (s)40.8(36.1，55.5)30.2(26.1，38.2)–5.6960.000
PT (s)19.7(17.4，23.8)14.1(12.6，15.5)–9.8340.000
TT (s)13.9(11.3，23.0)14.2(12.1，16.6)–0.8800.379
D-D (μg/ml)17.2(5.8，32.7)7.3(3.7，16.9)–3.0940.002
FDP (μg/ml)57.8(31.1，94.6)26.9(11.4，66.6)–3.3190.002
AT-Ⅲ(%)55.0(45.8，66.9)66.8(54.0，83.0)–2.7940.005
), ArticleFig(id=1211269172328264611, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表6, caption=

创伤性肺损伤INR≥1.36组与INR<1.36组患者常规凝血项目比较[M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)ZP
PLT (×109/L)97(55，126)123(86，172)–3.3540.001
FIB (g/L)1.19(0.77，1.90)2.20(1.58，3.53)–4.6680.000
APTT (s)40.8(36.1，55.5)30.2(26.1，38.2)–5.6960.000
PT (s)19.7(17.4，23.8)14.1(12.6，15.5)–9.8340.000
TT (s)13.9(11.3，23.0)14.2(12.1，16.6)–0.8800.379
D-D (μg/ml)17.2(5.8，32.7)7.3(3.7，16.9)–3.0940.002
FDP (μg/ml)57.8(31.1，94.6)26.9(11.4，66.6)–3.3190.002
AT-Ⅲ(%)55.0(45.8，66.9)66.8(54.0，83.0)–2.7940.005
), ArticleFig(id=1211269172416345001, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=EN, label=Tab.7, caption=

Comparison of TEG parameters between two groups of TLI patients [M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)ZP
R (min)7.4(5.8，10.4)6.8(5.6，8.5)–1.4270.154
K (min)4.2(2.8，7.9)2.4(2.0，3.7)–4.5180.000
Angle (°)41.3(29.7，54.0)56.6(45.6，62.0)–4.4780.000
MA (mm)42.1(32.4，50.4)53.1(45.9，62.4)–5.1290.000
CI–5.3(–10.7，–2.4)–2.1(–5.1，–1.0)–4.2740.000
), ArticleFig(id=1211269172525396911, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269163348259378, language=CN, label=表7, caption=

创伤性肺损伤INR≥1.36组与INR<1.36组患者TEG参数比较[M(Q1, Q3)]

, figureFileSmall=null, figureFileBig=null, tableContent=
项目INR≥1.36组(n=49)INR<1.36组(n=110)ZP
R (min)7.4(5.8，10.4)6.8(5.6，8.5)–1.4270.154
K (min)4.2(2.8，7.9)2.4(2.0，3.7)–4.5180.000
Angle (°)41.3(29.7，54.0)56.6(45.6，62.0)–4.4780.000
MA (mm)42.1(32.4，50.4)53.1(45.9，62.4)–5.1290.000
CI–5.3(–10.7，–2.4)–2.1(–5.1，–1.0)–4.2740.000
)], attaches=null, journal=Journal(id=1146441329971666965, delFlag=0, nameCn=解放军医学杂志, nameEn=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, issn=0577-7402, eissn=null, cn=11-1056/R, coden=null, periodic=0, language=CN, oaType=是, ccby=CC BY-NC-ND, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=6srot5PcoYX30Oa4xeTmeg==, journalPrice=null, startedYear=null, abbrevIsoEn=null, journalRemark=null, publicationField=null, createdTime=1751262512917, updatedTime=1761735725513, createdBy=18614031015, updatedBy=13701087609, firstLetterCn=M, firstLetterEn=M, subjectCode=Life Sciences, subjectName=Life Sciences, subjectCodeEn=Life Sciences, subjectNameEn=null, picCn=6srot5PcoYX30Oa4xeTmeg==, picEn=ELwBh5xqrSTlIs7HmSNt2Q==, jcr=null, cjcr=null, exts=[JournalExt(id=1190369167564968109, language=CN, name=解放军医学杂志, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725537, updatedTime=1761735725537, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1190369167615299758, language=EN, name=Medical Journal of Chinese People’s Liberation Army, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1761735725549, updatedTime=1761735725549, createdBy=13701087609, updatedBy=13701087609, submissionGuidelinesUrl=, submissionAuthorUrl=#, submissionEditorUrl=#, submissionReviewUrl=#, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1189873630562394117, websiteList=[Website(id=1189873845923287108, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN, language=CN, createTime=1761617631655, createBy=18614031015, updateTime=1761622010471, updateBy=18614031015, name=解放军医学杂志-中文, tplId=1146099689490845704, title=解放军医学杂志, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924939378520839, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=articleTextType, value=kx, createTime=1761629813284, updateTime=1761629813284, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939353355012, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=banner, value=null, createTime=1761629813278, updateTime=1761629813278, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939399492362, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=grayFlag, value=0, createTime=1761629813289, updateTime=1761629813289, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939344966403, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629813276, updateTime=1761629813276, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939412075276, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=minRunFlag, value=0, createTime=1761629813292, updateTime=1761629813292, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939374326534, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/file/pic, createTime=1761629813283, updateTime=1761629813283, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939407880971, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=silenceFlag, value=0, createTime=1761629813291, updateTime=1761629813291, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939361743621, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1761629813280, updateTime=1761629813280, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939386909448, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeColor, value=null, createTime=1761629813286, updateTime=1761629813286, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924939395298057, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873845923287108, code=themeStyle, value=null, createTime=1761629813288, updateTime=1761629813288, creator=18614031015, updator=18614031015)]), Website(id=1189873846057504839, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1189873630562394117, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN, language=EN, createTime=1761617631687, createBy=18614031015, updateTime=1761622030030, updateBy=18614031015, name=解放军医学杂志-英文, tplId=1146101810881728533, title=Medical Journal of Chinese People’s Liberation Army, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1189924968168223505, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=articleTextType, value=kx, createTime=1761629820148, updateTime=1761629820148, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968147251982, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=banner, value=null, createTime=1761629820143, updateTime=1761629820143, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968185000724, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=grayFlag, value=0, createTime=1761629820152, updateTime=1761629820152, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968138863373, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=logo, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic?fileId=+zXjYVhun8ZOAA6+aKx2hw==, createTime=1761629820141, updateTime=1761629820141, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968197583638, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=minRunFlag, value=0, createTime=1761629820155, updateTime=1761629820155, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968159834896, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/file/pic, createTime=1761629820146, updateTime=1761629820146, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968193389333, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=silenceFlag, value=0, createTime=1761629820154, updateTime=1761629820154, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968155640591, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1761629820145, updateTime=1761629820145, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968172417810, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeColor, value=null, createTime=1761629820149, updateTime=1761629820149, creator=18614031015, updator=18614031015), WebsiteProps(id=1189924968180806419, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1189873846057504839, code=themeStyle, value=null, createTime=1761629820151, updateTime=1761629820151, creator=18614031015, updator=18614031015)])], journalTitle=解放军医学杂志, weixinUrl=null, journalUrl=http://zh.jfjyxzz.org.cn/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Medical Journal of Chinese People’s Liberation Army, journalPhotoCn=6srot5PcoYX30Oa4xeTmeg==, journalPhotoEn=ELwBh5xqrSTlIs7HmSNt2Q==, journalFirstLetter=M, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false), detailUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.2021.04.08, detailUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/10.11855/j.issn.0577-7402.2021.04.08, pdfUrlCn=https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/PDF/10.11855/j.issn.0577-7402.2021.04.08, pdfUrlEn=https://castjournals.cast.org.cn/joweb/jfjyxzz/EN/PDF/10.11855/j.issn.0577-7402.2021.04.08, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, reference=null)
收藏切换
创伤性肺损伤相关凝血病的预警指标及其临床价值分析
收藏切换
PDF下载
林青伟 , 宋景春 * , 余婷 , 曾俊杰 , 吴阳 , 刘慧强 , 钟林翠
解放军医学杂志 | 临床研究 2021,46(4): 367-372
收起
收藏切换
解放军医学杂志 | 临床研究 2021, 46(4): 367-372
创伤性肺损伤相关凝血病的预警指标及其临床价值分析
全屏
林青伟, 宋景春* , 余婷, 曾俊杰, 吴阳, 刘慧强, 钟林翠
作者信息
  • 解放军联勤保障部队第908医院重症医学科，南昌 330002

    • 林青伟，硕士研究生，主要从事弥散性血管内凝血中西医结合治疗方面的研究

通讯作者:

宋景春，E-mail：
Analysis of warning indicators of coagulopathy related to traumatic lung injury and its clinical value
Qing-Wei Lin, Jing-Chun Song* , Ting Yu, Jun-Jie Zeng, Yang Wu, Hui-Qiang Liu, Lin-Cui Zhong
Affiliations
  • Intensive Care Unit, the 908th Hospital of Chinese PLA Logistical Support Force, Nanchang 330002, China
出版时间: 2021-04-28 doi: 10.11855/j.issn.0577-7402.2021.04.08
文章导航
收藏切换
摘要
收起

目的 探讨创伤性肺损伤(TLI)相关凝血病的预警指标及其临床价值。方法 回顾性分析2015年9月—2019年11月解放军联勤保障部队第908医院重症医学科收治的159例TLI患者的基础资料及入科时的血红蛋白(HGB)、血小板计数(PLT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶时间(TT)、D-二聚体(D-D)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白降解产物(FDP)和血栓弹力图(TEG)参数。依据TLI患者90 d预后分为生存组(n=141)与死亡组(n=18)，采用多因素Cox回归分析和ROC曲线分析筛选出危险因素INR，并根据INR截断值分为INR≥1.36组(n=49)与INR<1.36组(n=110)，进行组间比较及生存分析。结果 生存组INR、乳酸(Lac)、创伤严重程度(ISS)评分明显低于死亡组(Z=–4.493、–3.481、–3.177，P<0.01)，APTT、PT、R时间、K时间明显短于死亡组(Z=–3.275、–4.325、–3.300、–2.278，P<0.01)，氧合指数、PLT、HGB、AT-Ⅲ、血块最大强度(MA)、血块形成动力学(Angle)、凝血综合指数(CI)明显高于死亡组(Z/t=–4.053、–2.764、0.269、–2.159、–3.058、–3.294、–3.016，P<0.01)。多因素Cox回归分析结果显示，INR与TLI患者死亡明显相关(RR=4.882，95%CI 1.263~18.870，P=0.022)。ROC曲线分析结果显示，INR判断TLI患者死亡的曲线下面积(AUC)为0.826(P<0.0001)，敏感度为0.788，特异度为0.752，截断值为1.36。INR<1.36组生存率明显高于INR≥1.36组(P<0.0001)。与INR<1.36组比较，INR≥1.36组Lac、ISS评分均明显升高(P<0.05)，APTT、PT、K时间均明显延长(P<0.05)，氧合指数、PLT、HGB、AT-Ⅲ、MA、Angle、CI均明显降低(P<0.05)。结论 INR≥1.36可作为TLI相关凝血病发生的预警指标，TLI相关凝血病患者的死亡风险明显增加。

创伤  /  肺损伤  /  凝血病  /  国际标准化比值

Objective To study the warning indicators and clinical value of coagulopathy related to traumatic lung injury(TLI). Methods The data of 159 patients with TLI from September 2015 to November 2019 in the intensive care unit of the 908th Hospital of Chinese PLA Logistical Support Force were analyzed retrospectively, including their hemoglobin (HGB), platelet (PLT), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), thrombin time (TT), D-dimer (D-D), antithrombin Ⅲ (AT-Ⅲ), fibrin degradation product (FDP) and thromboelastography.According to the 90-d prognosis of patients with TLI, they were divided into survival group (n=141) and death group (n=18). COX regression analysis and ROC curve analysis were carried out, and the risk factors INR were screened out. The patients were divided into INR≥1.36 group (n=49) and INR<1.36 group (n=110) for analysis. Results In survival group, INR, lactate (Lac), and injury severe score (ISS) score were significantly lower than those in death group (Z=–4.493, –3.481, –3.177, P<0.01); APTT, PT, R time and K time were much shorter than death group (Z=–3.275, –4.325, –3.300, –2.278, P<0.01); Oxygenation index, PLT, HGB, AT-Ⅲ, blood clots maximum intensity (MA), blood clot formation dynamics (Angle) and coagulation index (CI) were significantly better than those in death group (Z/t=–4.053, –2.764, 0.269, –2.159, –3.058, –3.294, –3.016, P<0.01). Cox regression analysis showed that INR (RR=2.18, 95%CI 1.07-4.43, P=0.031) were significantly correlated with the death of TLI patients. ROC curve analysis showed that the area under the curve for INR to judge the death of TLI patients was 0.826 (P<0.0001), the cut-off value was 1.36 (P<0.0001)and the sensitivity and specificity were 0.788 and 0.752, respectively. The survival rate in INR<1.36 group was significantly higher than that in INR≥1.36 group (P<0.0001). Compared with INR<1.36 group, in INR≥1.36 group, the Lac and ISS score significantly increased (P<0.05); APTT, PT and K time significantly prolonged (P<0.05); the oxygenation index, PLT, HGB, AT-Ⅲ, MA, Angle and CI decreased significantly (P<0.05). Conclusions TLI patients with INR≥1.36 can be used as an early warning indicator of TLI-related coagulopathy, and the risk of death of TLI related coagulation disease patients is significantly increased.

trauma  /  lung injury  /  coagulation disease  /  international standardized rate
林青伟, 宋景春, 余婷, 曾俊杰, 吴阳, 刘慧强, 钟林翠. 创伤性肺损伤相关凝血病的预警指标及其临床价值分析. 解放军医学杂志, 2021 , 46 (4) : 367 -372 . DOI: 10.11855/j.issn.0577-7402.2021.04.08
Qing-Wei Lin, Jing-Chun Song, Ting Yu, Jun-Jie Zeng, Yang Wu, Hui-Qiang Liu, Lin-Cui Zhong. Analysis of warning indicators of coagulopathy related to traumatic lung injury and its clinical value[J]. Medical Journal of Chinese People’s Liberation Army, 2021 , 46 (4) : 367 -372 . DOI: 10.11855/j.issn.0577-7402.2021.04.08
正文
收起
胸外伤临床较为常见，占所有外伤的60%左右[1]，其中创伤性肺损伤(traumatic lung injury，TLI)则占胸外伤的30%~75%，是创伤导致死亡的重要原因之一[2]。凝血紊乱是TLI的常见并发症，也是导致TLI病死率升高的重要原因[3-4]。TLI相关凝血病的发生主要与组织损伤、炎症、合并休克、酸中毒、低体温及血液稀释等因素有关[5-6]。已有研究发现，TLI时凝血相关标志物如假性血友病因子(von Willebrand's factor，vWF)、纤溶酶原活化抑制物-1(plasmino-gen activator inhibitor-1，PAI-1)和C5a等升高且提示预后不良[7-8]。目前，创伤性凝血病多以凝血酶原时间(prothrombin time，PT)和活化部分凝血活酶时间(activated partial thromboplastin time，APTT)延长、国际标准化比值(international normalized ratio，INR)升高为诊断依据，但具体标准尚无定论[9]。为此，本研究探讨了TLI相关凝血病的预警指标，并对其临床价值进行评估。
1 资料与方法
收起
1.1 研究对象
回顾性分析2015年9月—2019年11月解放军联勤保障部队第908医院重症医学科收治的159例TLI患者的临床资料，其中男128例，女31例，年龄18~88(48.6±17.5)岁。纳入标准：年龄≥18岁；胸部CT结果提示肺损伤；伤后4 h内入重症医学科。排除标准：存在已知的先天性凝血功能紊乱；存在肺基础疾病；存在中重度肝病；正在接受抗凝治疗；院前心肺复苏的患者。依据TLI患者90 d预后分为生存组(n=141)与死亡组(n=18)。本研究经解放军联勤保障部队第908医院伦理委员会批准(LC2018028)。
1.2 数据收集
收集患者入院时创伤严重程度(ISS)评分、氧合指数(氧分压/氧浓度)、乳酸(Lac)水平、机械通气状况及ICU住院时间等资料，记录患者受伤后90 d的结局。收集患者入科2 h的血常规项目[包括血红蛋白(hemoglobin，HGB)、血小板计数(platelet，PLT)等]、常规凝血项目[包括纤维蛋白原(fibrinogen，FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(thrombin time，TT)、D-二聚体(D-dimer，D-D)、抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白降解产物(fibrin degradation product，FDP)等]及血栓弹力图(thromboelastography，TEG)参数[包括凝血反应时间(R)、血块形成速率(K)、血块形成动力学(Angle)、血块最大强度(MA)、凝血综合指数(CI)等]。
1.3 统计学处理
采用SPSS 25.0软件进行统计分析。计数资料以例(%)表示，组间比较采用χ2检验；计量资料采用单样本S-W法进行正态分布检验，符合正态分布的数据以$\bar{x}±s$表示，非正态分布的数据以M(Q1，Q3)表示；满足正态分布且方差齐者采用t检验，方差不齐者采用非参数秩和检验；非正态分布数据组间比较采用非参数检验(Mann-Whitney U秩和检验)。采用多因素Cox回归分析筛选TLI患者的预后危险因素，采用ROC曲线分析INR对TLI患者预后的判断价值，组间生存率比较采用Kaplan-Meier法。P<0.05为差异有统计学意义。
2 结果
收起
2.1 两组基础资料比较
两组年龄、性别、致伤原因和合并损伤情况差异无统计学意义(P>0.05)。与生存组比较，死亡组Lac水平、ISS评分和机械通气比例明显升高(P<0.05)，氧合指数、HGB明显降低(P<0.05)，ICU住院时间明显缩短(P<0.05)(表1)。
2.2 两组凝血功能比较
与生存组比较，死亡组APTT、PT明显延长(P<0.05)，INR明显升高(P<0.05)，PLT、FIB、AT-Ⅲ明显降低(P<0.05)；两组TT、D-D和FDP比较差异无统计学意义(P>0.05，表2)。
2.3 两组TEG参数比较
与生存组比较，死亡组R时间、K时间明显延长(P<0.05)，MA、Angle、CI明显降低(P<0.05，表3)。
2.4 TLI患者预后影响因素的多因素Cox回归分析
将性别、年龄、致伤原因、氧合指数、ISS评分、Lac水平、HGB、PLT、APTT、PT、INR、TT、FIB、D-D、FDP、AT-Ⅲ，以及TEG参数(R时间、K时间、Angle、MA、CI)纳入多因素Cox回归分析，筛选影响TLI患者预后的风险因素，结果显示，INR与TLI患者预后明显相关(P<0.05，表4)。
2.5 INR判断TLI患者预后的ROC曲线分析
将INR纳入ROC曲线分析，曲线下面积(AUC)为0.826(95% CI 0.706~0.903，P<0.0001)。INR判断TLI患者预后的截断值为1.36时，敏感度为0.778，特异度为0.752(图1)。
2.6 INR≥1.36组与INR<1.36组生存率比较
按照INR判断TLI患者预后的截断值将患者分为INR≥1.36组(n=49)与INR<1.36组(n=110)，结果显示，INR<1.36组的生存率明显高于INR≥1.36组(P<0.0001，图2)。
2.7 INR≥1.36组与INR<1.36组基础资料比较
两组年龄、性别、致伤原因及ICU住院时间差异无统计学意义(P>0.05)。与INR<1.36组比较，INR≥1.36组病死率、Lac水平、ISS评分、机械通气比例明显升高(P<0.05)，氧合指数、HGB明显降低(P<0.05)(表5)。
2.8 INR≥1.36组与INR<1.36组常规凝血项目比较
与INR<1.36组比较，INR≥1.36组APTT、PT明显延长(P<0.05)，D-D、FDP明显升高(P<0.05)，PLT、HGB、FIB、AT-Ⅲ明显降低(P<0.05)；两组TT比较差异无统计学意义(P>0.05，表6)。
2.9 INR≥1.36组与INR<1.36组TEG参数比较
与INR<1.36组比较，INR≥1.36组K时间明显延长(P<0.05)，MA、Angle、CI明显降低(P<0.05)；两组R时间比较差异无统计学意义(P>0.05，表7)。
3 讨论
收起
目前，国内外关于TLI相关凝血病预警指标的报道较少。本研究结果显示，INR是影响TLI患者预后的危险因素，且INR≥1.36可作为TLI相关凝血病的预警指标。
本研究对2015年9月—2019年11月解放军联勤保障部队第908医院重症医学科收治的159例TLI患者进行回顾性分析，结果显示，生存组与死亡组年龄、性别、致伤原因和合并损伤情况差异无统计学意义，但死亡组在入院时的Lac水平、ISS评分、机械通气比例、INR明显升高，APTT、PT、R时间、K时间明显延长，氧合指数、PLT、HGB、AT-Ⅲ、MA、Angle、CI明显降低，表明死亡组入院时即存在严重的凝血功能障碍。将性别、年龄、致伤原因、氧合指数、ISS评分、Lac水平、HGB、PLT、APTT、PT、INR、TT、FIB、DD、FDP、AT-Ⅲ和TEG参数纳入多因素Cox回归分析，结果显示，INR与TLI患者预后明显相关，表明凝血功能紊乱是影响TLI患者预后的重要因素。INR是由PT计算而来的，代表外源性凝血途径。考虑创伤造成组织损伤时，首先激活外源性凝血途径，且INR是临床开展较为广泛的检测项目，因此更适合作为TLI相关凝血病的诊断方法。既往有研究将INR>1.5作为创伤性凝血病的诊断标准[10]，将INR>1.3作为创伤性脑损伤相关凝血病的诊断标准[11]，以便诊断创伤相关凝血病并进行早期治疗。迄今为止，国内外关于TLI相关凝血病预警指标的研究较少。
本研究结果显示，当INR的截断值为1.36时，根据INR判断TLI患者预后不良的AUC为0.826(95% CI 0.706~0.903)，诊断敏感度为0.778，特异度为0.752。因此按照INR截断值将TLI患者分为INR≥1.36组与INR<1.36组，进一步分析发现，两组年龄、性别和致伤原因并无明显差异，但INR≥1.36组的死亡风险是INR<1.36组的8.8倍(P<0.0001)，提示INR≥1.36可作为TLI相关凝血病的预警指标。
创伤并发凝血功能紊乱时病死率明显升高。本研究结果表明，TLI患者INR≥1.36提示凝血功能紊乱，低于普通创伤患者的INR>1.5，分析原因主要与TLI的发病机制有关。TLI常合并肋骨骨折、创伤性血气胸和急性呼吸窘迫综合征，这些疾病本身即为引发凝血功能紊乱的危险因素[12]。严重创伤常合并休克、酸中毒、低体温、血液稀释等因素，可加速TLI相关凝血病的发生[13-14]。已有研究发现，TLI早期即出现核因子κB(nuclear factor-kappa B，NF-κB)、白细胞介素-33(interleukin-33，IL-33)、胞质蛋白伴侣分子(Kelch-like ECH-associated protein，Keap1)等表达增加，这些炎性介质可促进凝血进程的启动，导致凝血因子消耗增加，促进创伤早期高凝状态向低凝状态的转变，这为深入探讨TLI相关凝血病的发生机制提供了依据[15-17]。
综上所述，本研究结果表明，INR≥1.36可作为TLI相关凝血病发生的预警指标，TLI相关凝血病患者的死亡风险为TLI未合并凝血病者的8.8倍。但本研究为单中心回顾性研究，样本量较少。下一步的研究方向应选择INR≥1.36与普通创伤的INR>1.5诊断标准进行对照，采用前瞻性方法研究TLI相关凝血病的诊断标准。
基金
收起
  • 江西省卫健委科技计划(20204818)
  • 江西省卫健委科技计划(20195684)
文献
收起
参考文献 引证文献
排序方式：
[1]
Homo RL, Grigorian A, Lekawa M, et al. Outcomes after pneumonectomy versus limited lung resection in adults with traumatic lung injury[J]. Updates Surg, 2020, 72(4): 547-553.
[2]
Platz JJ, Loic F, Norotsky M, et al. Thoracic trauma: injuries, evaluation, and treatment[J]. Surg Clin North Am, 2017, 97(4): 783-799.
[3]
Störmann P, Lustenberger T, Relja B, et al. Role of biomarkers in acute traumatic lung injury[J]. Injury, 2017, 48(11): 2400-2406.
[4]
Calfee CS, Eisner MD, Ware LB, et al. Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders[J]. Crit Care Med, 2007, 35(10): 2243-2250.
[5]
Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition[J]. Crit Care, 2019, 23(1): 98.
[6]
Tang LQ, Zhang XQ, Tong HS, et al. The effect of serum HMGB1 levels on the severity and prognosis of critical ill patients with early trauma-induced coagulopathy in the intensive care unit[J]. Med J Chin PLA, 2020, 45(11): 1144-1150.
[唐丽群, 张兴钦, 童华生, 等. 血清HMGB1水平对创伤性凝血病早期危重患者病情及预后的影响[J]. 解放军医学杂志, 2020, 45(11): 1144-1150.]
[7]
Ware LB, Koyama T, Zhao Z, et al. Biomarkers of lung epithelial injury and inflammation distinguish severe sepsis patients with acute respiratory distress syndrome[J]. Crit Care, 2013, 17(5): R253.
[8]
Hoth JJ, Wells JD, Jones SE, et al. Complement mediates a primed inflammatory response after traumatic lung injury[J]. J Trauma Acute Care Surg, 2014, 76(3): 601-608.
[9]
Stensballe J, Henriksen HH, Johansson PI. Early haemorrhage control and management of trauma-induced coagulopathy: the importance of goal-directed therapy[J]. Curr Opin Crit Care, 2017, 23(6): 503-510.
[10]
Palmer L, Martin L. Traumatic coagulopathy-Part 1: Pathophysiology and diagnosis[J]. J Vet Emerg Crit Care (San Antonio), 2014, 24(1): 63-74.
[11]
Maegele M. The diagnosis and treatment of acute traumatic bleeding and coagulopathy[J]. Dtsch Arztebl Int, 2019, 116(47): 799-806.
[12]
Maduka AKI, Lin GJ, Lim WW, et al. A comprehensive analysis of traumatic rib fractures in an Acute General Hospital in Singapore[J]. J Emerg Trauma Shock, 2019, 12(2): 145-149.
[13]
Petros S. Trauma-induced coagulopathy[J]. Hamostaseologie, 2019, 39(1): 20-27.
[14]
Liu W, Cai JK. Influences of ulinastatin on acute lung injury and time phase changes of coagulation parameters in rats with burn-blast combined injuries[J]. Chin J Burns, 2018, 34(1): 32-39.
[刘伟, 柴家科. 乌司他丁对烧冲复合伤大鼠急性肺损伤及凝血参数时相性变化的影响[J]. 中华烧伤杂志, 2018, 34(1): 32-39.]
[15]
Shao XF, Li B, Shen J, et al. Ghrelin alleviates traumatic brain injury-induced acute lung injury through pyroptosis/NF-κB pathway[J]. Int Immunopharmacol, 2020, 79: 106175.
[16]
Halát G, Haider T, Dedeyan M, et al. IL-33 and its increased serum levels as an alarmin for imminent pulmonary complications in polytraumatized patients[J]. World J Emerg Surg, 2019, 14: 36.
[17]
Hu LY, Cui JB, Xu XM, et al. Expression of Nrf2-Keap1-ARE signal pathway in traumatic lung injury and functional study[J]. Eur Rev Med Pharmacol Sci, 2018, 22(5): 1402-1408.
2021年第46卷第4期
PDF下载
178
71
引用本文
BibTeX
文章信息
doi: 10.11855/j.issn.0577-7402.2021.04.08
  • 接收时间：2020-06-16
  • 首发时间：2025-12-26
  • 出版时间：2021-04-28
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期：2020-06-16
  • 修回日期：2021-02-04
基金
Science and Technology Plan of Jiangxi Provincial Health Commission(20204818)
江西省卫健委科技计划(20204818)
Science and Technology Plan of Jiangxi Provincial Health Commission(20195684)
江西省卫健委科技计划(20195684)
作者信息
    解放军联勤保障部队第908医院重症医学科，南昌 330002

通讯作者:

宋景春，E-mail：
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/jfjyxzz/CN/10.11855/j.issn.0577-7402.2021.04.08
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏
相关链接
论文
最新文章
热读文章
热点专题
内参
蓝皮书
产业发展报告
传播力报告
期刊分级目录
资讯
学术新闻
行业新闻
学术会议
行业会议
关于
关于我们
联系我们
北京市海淀区学院南路86号
100081
010-62199257
qkjq@cast.org.cn

中国科学技术协会版权所有 京ICP 备10216604号-4 海淀分局备案 1101084647
科技导报社主办 中国科协信息中心技术支持