烧伤患者肠道内IgA水平变化的动态观察

Kinetic changes of IgA levels in intestinal tract in burned patients

目的：探讨烧伤患者肠道屏障损伤的规律以及建立一种反映肠道屏障损伤情况的临床检测指标的可能性。方法：采用酶联法测定１３例平均烧伤面积为６１．２％（三度烧伤２９．４％）烧伤患者肠道内ＩｇＡ水平的变化。结果：烧伤后肠道内ＩｇＡ水平总体呈下降趋势，但烧伤面积大于７０％的患者在伤后第一、第二周高于对照组。结论：烧伤后肠道内ＩｇＡ水平的降低，反映肠道免疫屏障受损伤；如肠道内ＩｇＡ水平在伤后早期明显升高，提示烧伤对患者打击巨大，或发生严重创面感染等并发症；在治疗过程中，肠道内ＩｇＡ水平明显升高，提示病情严重。

Objective:To investigate the relationship between the damage of intestinal barrier and gutderived sepsis,and the possibility of IgA levels in reflecting intestinal barrier damage in clinic.Methods:The IgA level in intestinal tract of thirteen burned patients (average 61.2% TBSA, Ⅲ° 294%) was measured.Results:It was foung that IgA levels in intestinal content tended to decrease in all patients after major burns. However, increases of IgA in patients with more than 70% TBSA in first week and second week afterburns and significant declines in patients with less than 70% TBSA in first and third week after injury were observed.Conclusion:The results indicated that the intestinal barrier was damaged after burns. The increase of IgA level in intestinal tract in the early stage after burns may be related to severe stress to patients or serious wound infection and other complications. On the other hand, the assay of IgA level in intestinal content is simple and easy, suggesting that IgA may be an useful parameter to reflect the intestinal barrier damage in burned patient.