Eritropoetin kao biološki marker procene ishoda lečenja politraumatizovanih pacijenata
Erythropoietin as a biomarker In outcome evaluation of politraumatized patients
Докторанд
Arsenijević, VladimirМентор
Jeremić, VasilijeЧланови комисије
Šijački, AnaAlempijević, Tamara
Pavlović, Aleksandar
Метаподаци
Приказ свих података о дисертацијиСажетак
Trauma je jedan od najznačajnijih problema razvijenog sveta. Ona je treći
uzrok smrti posle kardiovaskularnih i malignih bolesti, a prvi u najvitalnijoj
životnoj populaciji. Trauma je akutno oštećenje organizma sa razaranjem tkiva i
odgovarajućim funkcionalnim poremećajem, prouzrokovano delovanjem neke
spoljašnje sile (mehanička, termička, hemijska, aktinička). Procenjivanje stepena
obolelosti organizma predstavlja jedan od osnovnih postupaka u medicinskoj
praksi. Eritropoetin je endogeni hormon za koji u poslednje vreme vlada veliko
interesovanje za primenu u proceni i terapiji pacijenata.
C-reaktivni protein (CRP) je protein koji se stvara u jetri, a čija je povećana
koncentracija u serumu direktno povezana sa postojećom inflamacijom u
organizmu. IL-6 je citokin koji se stvara kao odgovor na stimulans u širokom
spektru imunološki aktivnih ćelija. Važan je u stvaranju reaktanata akutne faze od
strane hepatocita i izgleda da je glavni vodič impulsa koji upravljaju njihovom
sekrecijom.
...Cilj: Analiza epidemioloških podataka politraumatizovanih bolesnika (pol i uzrast),
uzroka povređivanja, kao i procena težine provreda na osnovu kliničkih
(anatomskih i fizioloških) skorova. Praćenje vrednosti koncentracije eritropoetina
i njene korelacije sa vrednostima hemoglobina, IL-6 i kliničkih skorova. Analiza
korelacije koncentracija eritropoetina sa ishodom lečenja politraumatizovanih
pacijenata
Metode: U ovo istraživanje uključena su 43 bolesnika lečenih zbog politraume. Za
svakog pacijenta su prikupljani sledeći podaci: uzrast, pol, tip povrede, etiologija
povređivanja. Pacijenti su skorovani po: ISS skoru, AIS skoru, APACHE II i SOFA
skoru. Takođe je praćena količina primljene transfuzije krvi i krvnih derivata, broj
dana hospitalizacije i ishod lečenja. Po prijemu, a zatim 24h, 48h, 72h i sedmog
dana pacijentima je uzimana krv za biohemijske analize...
Introduction: Traumatic injuries are one of the most important problems in
developed world. They are the third cause of death after cardiovascular and
neoplastic diseases. They are the first leading cause of death in the most
productive population. Trauma is defined as an acute organ and system of organs
damage accompanied by functional disarrangements caused by some external
forces (mechanical or chemical). Evaluation of the degree of the injuries is one of
the most important initial steps in clinical care of these patients. Erythropoietin is
an endogenous hormone that recently has been evaluated as a prognostic and
therapeutic maker in different patients’ populations.
C-reactive protein (CRP) is a protein synthetized in the liver and its concentration
in blood correlates with inflammation. IL-6 is a cytokine, produced in many
different immunologically active cells as a result of inflammation. It is an essential
element in formation of acute phase reactant by hepatocytes and seems to ...be the
main regulator in their synthesis and secretion.
Goal: To evaluate epidemiological data of patients with polytrauma (age and sex),
cause leading to the injury as well as prediction of severity of injury by clinical
(anatomic and physiologic) scores. Furthermore we trended erythropoietin levels
and investigated if they correlate with hemoglobin levels, IL-6 levels as well as
clinical scores.
Methods: This study included 43 patients who were hospitalized following trauma
leading to multiple organ injuries. Date consisting of age, sex, type and the cause of
injury were collected from the patients’ charts. Patients were further scored by ISS,
AIS, SOFA and APACHE score. Additionally we evaluated number of red blood cells
units that were transfused, length of stay (LOS) and outcome.
Results: This study included 43 patients with polytrauma of whom 32 (74.52%)
were male and 11 (25.58%) were female. Most common cause of polytrauma was
due to motor vehicle accidents (MVA) - 27 (62.8%) followed by falls 13 (30.2%)
and the other causes were described in 3 patents (7%)...