严重烧伤早期切痂对可溶性脂多糖受体CD14表达和肝损害的影响

Effects of escharectomy on soluble CD14(sCD14) and complicated liver injury in severely burned patients

目的 研究休克期切痂对严重烧伤后可溶性脂多糖受体CD14 (sCD14 )和肝损害的影响 ,并探索其可能的内在机制。方法 收集休克期切痂组和非休克期切痂组的大面积烧伤病人血标本 ,检测内毒素 (LPS)、sCD14和肿瘤坏死因子 (TNF-α)含量 ,同时测定血清谷丙转氨酶 (ALT)和谷草转氨酶 (AST)的水平。结果 休克期切痂组的上述指标均明显低于非休克期切痂组 (P <0 .0 5 ) ,sCD14和各项指标呈正相关。结论 严重烧伤后LPS、sCD14和TNF -α途径是并发肝功能损害的一条重要途径 ,休克期切痂可能通过该途径在一定程度上控制早期主要炎症介质的释放 ,降低烧伤后肝损害的程度。

Objective To investigate the effects of escharectomy during burn shock stage on sCD14 and complicated liver injury in patients with burns. Methods We compared the levels of lipopolysaccharide(LPS), sCD14, tumor necrosis factor-α(TNF-α), aspartate aminotransferase(AST) and alanine aminotransferase(ALT) in serum of patients with different therapy in two groups. Results All the markers mentioned above in patients with escharectomy were lower than those of patients with regular therapy, and positive correlation was found between sCD14 and other markers. Conclusion Our data suggest that there is an important pathway among LPS, sCD14 and TNF-α, which might lead to liver injury in severely burned patients, and by which escharectomy control the release of main inflammation media and relieve the live injury to some extent.