烧伤后某些急性期蛋白反应物的变化及其临床意义

Dynamic Changes of Some Acutephase Protein Reactants and Their Clinical Significance in Severe Burn Patients

测定了烧伤病人伤后血清中4种急性期蛋白反应物的变化并分析了与败血症及死亡的关系。其中C-反应蛋白,α_1-抗胰蛋白酶伤后升高,其变化趋势有助于预测和诊断烧伤败血症的发生。α_2-巨球蛋白的降低与败血症的发生也有关系。若α_2-巨球蛋白持续下降和α_1-酸性糖蛋白明显升高有助于判断烧伤病人的预后。因此观察急性期蛋白反应物的变化是监测病人病情变化的有益指标。

By immunoquantitation of nephelometry or agar single-diffusion, four scram acute-phase protein reactants were serially measured in 24 patients with TBSA more than 30% and their clinical significance was analysed. Creactive protein and alpha 1-antitrypsin increased markedly and persisted at a high level throughout the whole five week study period. A sudden and more marked elevation happened at about 48 hr before sepsis. In addition, it was also worth noticing that their initial elevation （within 3 days postburn） in septic and nonsurvival groups were less than that in the nonseptic and survival ones Alpha 2-macroglobulin was at the subnormal level throughout the observation period, but a far more reduction occurred during sepsis. Alpha 1-acid glycoprotein exhibited a obvions increase following burn, which trended to be more significant before the expiration of patients Therefore, the laboratory observation on the changes of the acute-phase protein reactant is of the great importance to the prediction and diagnosis of horn sepsis and judgement of the severity of patients.