肾功能放免联检在严重烧伤的应用

The Application of Renal Functions Radioimmunoassay in Serious Burns

严重烧伤肾功能放免七项蛋白系列联检是早期判断肾功能的灵效指标。我们对71例烧伤面积30％以上的病人（平均烧伤面积60.40±19．24）按四个时相期（休克、回收、感染、感染后期），进行尿蛋白（ALb）、血清和尿β2-微球蛋白（β2－m）、免疫球蛋白G（IgG）、粘蛋白（THP）肾功能放免七项动态系列联检，结果提示伤后尿ALb、IgG、THP、血清和尿β2-m均明显升高，但血清IgG下降。通过检测尿中分子量不同的蛋白质便可反映肾小球通透性的变化和肾小球功能受损的程度。血β2-m是估价肾小球滤过功能的灵效指标且灵敏于Cr（血肌酐），特别是在血Cr处于盲区，同时可作为测量GFR（肾小球滤过率）理想的内生物质，尿β2－m及THP的RIA（放射免疫测定）对肾小管（近曲、远曲）损伤部位具有定位作用，通过对系列联检数据的综合分析可以全面了解和评估全肾功能损伤情况，它们之间互补性很强，对临床诊断有指导意义。

Renal functions radioimmunoassay is a sensitivemethod for diagnosing the changes of renal functionsin the early stage of burn. The urine Alb, serum andurine β2-m, lgG, and THP were serially determinedwith radioimmunoassay to assess the renaI functionsduring various stages of burn in 71 patients with TBSAover 30% (X±S = 6O． 4O%±19． 24%). It was foundthat the urine levels of Alb, IgG and THP and theserum and urine levels of 5,-m were remarkedly in-creased and that the serum Ievels of IgG were de-creased after burns. The results of examining differen-tial molecular weight proteins of urine may mirror thechanges of glomerular permeability and degree of in-jury. Blood 5,-m change is a sensitive target evaluat-ing glomerular filtration function, especially, whenblood creatinine is in blind zone- Urine 5z-m and THP(mucin)RIA have the locating role in renal tubes in-Juries (proximal convoluted tube, distant convolutedtube). Renal functions radioimmunoassay method iseasy to ooperate, its blood and urinary samplings areconvenient,the providing data are seriation, its credi-bility is high and is easy to popularize.