毒鼠强急性中毒患者血清前白蛋白和透明质酸酶的变化及意义

Changes and significance of serum prealbumin and hyaluronic acid in patients with acute tetramethylene disulfoteraminepoisoning

目的探讨血清前白蛋白(prealbumin,PAB)和透明质酸酶(hyaluronicacid,HA)在毒鼠强急性中毒患者中的变化及意义。方法将198例毒鼠强(tetramine)中毒患者分成轻度、中度和重度中毒3个组,另选198例健康人为正常对照组,各组均采用免疫散射比浊法检测血浆PAB的含量,应用放射免疫法检测血浆HA含量。结果毒鼠强轻度中毒组患者血清PAB、HA含量与正常对照组比较,差异有统计学意义(P<0.01),而常规肝功指标AST、ALT、总胆红素、总蛋白、白蛋白与正常比较,差异无统计学意义(P>0.05);随着中毒程度的加重,HA含量,AST、ALT、总胆红素逐渐上升,血清PAB逐渐下降。结论毒鼠强患者血清PAB和HA含量的变化可作为反映毒鼠强中毒肝功能损害的敏感指标,而在一定程度上可作为反映毒鼠强病情轻重的指标。对及时调整治疗方案,防治肝功能损害的发生、发展有一定的临床意义。

Objective To investigate the changes and significance of serum prealbumin(PAB)and hyaluronic acid(HA)in patients with acute tetramethylene disulfoteramine(tetramine)poisoning(ATP).Methods Peripheral blood samples were collected form 198 patients with ATP,divided into mild,moderate,and severe poisoning groups,and 198 healthy controls.Serum HA was measured with radioimmunoassay and PAB was measured with immune scatter turbidimetry method.Liver function tests,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin,total protein,and albumin(ALB),were conducted.Results The serum PAB values of the ATP patients of different degrees were all significantly lower than that of the controls(all P<0.01),and the higher the severity,the lower the PAB value.The serum HA levels of the ATP patients of different degrees were all significantly higher than that of the healthy controls(all P<0.01),and the higher the severity,the higher the HA level.The AST,ALT,and TB levels of the moderate and severe ATP patients were all significantly higher than those of the controls(all P<0.05).The total protein of the moderate and severe ATP patients were both lower than that of the control(both P<0.05).The ALB level of the severe ATP patients was significantly lower than that of the controls(P<0.05).Conclusion Sensitive indicis of liver damage,serum PAB and HA can serve as indicis in judging the severity of ATP.