摘要
严重烧伤后血浆特定蛋白浓度发生明显改变，通过对29例TBSA30～97％（平均50．03±21．16）严重烧伤病人10项特定蛋白C3（补体C3）、C4（补体C4）、IgA（免疫球蛋白肋、IgM（免疫球蛋白M）、ALB（白蛋白）、PAB（前清蛋白）、TRF（转铁蛋白）、CER（铜兰蛋白）、HAP（结合珠蛋白）、AAT（α－1抗胰蛋白酶），分四个时相（2、7、14、21天），用法国赛诺菲集团生产的QM300全自动特定蛋白分析系统进行动态联检，观察严重烧伤后血浆特定蛋白的代谢变化及其临床意义，数据经多元方差分析，t检验，正常人对照组作为各项指标伤前对照。C3、C4、PAB、ALB、TRF、CER降低非常显著（P＜0．001），C3、C4恢复较慢且与烧伤严重程度呈负相关；CER、TRF、PAB、ALB伤后一周内降低非常显著（P＜0．001），在14-21天开始恢复且伤情愈重，恢复愈慢。IgA、IgM在伤后2天时降低非常显著（P＜0．001），IgM随之逐渐回升，IgA可持续一周，AAT各时相均呈非常显著升高（P＜0．001），同组各时相间差异不显著，伤情愈重，升高愈剧；HAP在伤后7天升高显著（P＜0．05），组间及各时相间差异不显著。严重烧伤后这些特定蛋白总的变化趋势，认为严重烧伤后在内稳态失恒的状态下，血浆蛋白的变化，直接影响到血浆蛋白的免疫、载运、营养、
The plasma level of some specified proteins changed significantly post burn. This paper reports the plasma level of 10 specified proteins of 29 patients with burn area, 30% to 97% TBSA(average 50. 03±21.16% ). The proteins included complement C3 (C3), complement C4 (C4 ), immunoglobulin A (IgA), Immunoglobulin M (IgM), albumin (ALB), prealbumin (PAB), transferrin(TRF), ceruloplasmin (CER), haptoglobin (HAP) and α- antitrypsin (AAT). The analyses werecarried out at 2, 7 14 and 21 d post burn using a French made specified protein automatic analyserQM300. The data were compared with those of the normal persons and treated statistically by F testarid t test. The results revealed that post severe burn, C3, C4, PAB, ALB, TRF and CER levels lowered significantly (P < 0. 001 ). C3 and C4 levels returned to normal very slowly and were negativelyrelated to the severity of burn; CER, TRF, PAB and ALB levels lowered very significantly in oneweek post burn (P<0.001) and began to recover at 14 to 21 d post burn, the more the severity ofburn, the slower the recovery. IgA and IgM levels lowered very significantly at 2 d post burn (P<0.001). then IgM level recovered, while IgA kept at a low level for one week. AAT level increased verysignificantly at different time intervals (P<0.001 ); the difference between different time intervals wasnot significant; the more the severity of burn, the more the increase in plasma level. HAP level increased significantly at 7 d Post burn (< 0.05 ); the difference between groups and different time intervals was not significant. These results revealed that changes in specified protein level in plasma is responsible to the changes in the physiological functions of plasma, such as immunology, transportation,nutrition supply as well as wound recovery. It has great effect on many aspects of burn treatment, suchas shock, infection and wound management. Timely regulation of the level of specified protein in plasma to maintain at a constant level is of great clinical significance.
出处
《中国烧伤创疡杂志》
1999年第1期8-13,共6页
The Chinese Journal of Burns Wounds & Surface Ulcers
