Effects of different degrees of spinal cord injury on adrenal morphology and function in patients with multiple trauma
Objective To explore the effects of different degrees of spinal cord injury(SCI)on adrenal morphology and function in patients with multiple trauma.Methods A total of 145 patients with multiple trauma and SCI admitted in the trauma center of the Affiliated Hospital of Zunyi Medical University from November 2021 to November 2023 were selected as the research objects.According to the Injury Severity Score(ISS),the patients were divided into mild trauma group(ISS score<16 points)and severe trauma group(ISS score≥16 points),and the degree of SCI was graded according to the American Spinal Injury Association(ASIA)standard.The levels of hemoglobin(Hb)and adrenal volume were compared between the two groups;the levels of cortisol and adrenocorticotropic hormone(ACTH)in patients with different SCI grades were compared between the two groups.Results There were 68 cases of mild trauma and 77 cases of severe trauma in patients with multiple trauma and SCI.The ISS score of the mild trauma group was lower than that of the severe trauma group,and the Hb level was higher than that of the severe trauma group(P<0.05).SCI classification showed that 48 cases were grade A,39 cases were grade B,26 cases were grade C,and 32 cases were grade D;there were no significant differences in cortisol and ACTH levels between patients with different SCI grades in the two groups(P>0.05);the levels of cortisol and ACTH in the mild trauma group were higher than those in the severe trauma group(P<0.05).There were no significant differences in the left,right and total volume of adrenal gland between the two groups(P>0.05).Conclusion Acute SCI does not lead to relative changes in adrenal volume in the short term,and patients with severe multiple trauma are more likely to show adrenal insufficiency.
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