烧伤病人血浆内毒素水平动态变化及临床意义探讨

Changes of plasma endotoxin level and its clinical significance in burn patients

目的：通过检测血浆内毒素水平，探讨烧伤病人内毒素血症出现的规律及其与临床征象、治疗措施的相互关系。方法：随机选择33例住院病人，平均烧伤面积48．5％，Ⅲ°面积14．7％，定期采集静脉血用鲎试验的偶氮显色定量法检测血浆内毒素含量，进行统计学处理分析。结果：内毒素血症（＞40ng／l）总发生率92／192（48％），烧伤3天后与Ⅲ°面积、体温呈正相关，与中性白细胞％呈负相关。三例特大面积烧伤病人伤后40～50天内毒素水平再次呈现高峰。结论：鉴于影响内毒素血症的临床因素及其引起的机体反应均较复杂，其临床意义有待进一步探讨。

Aim: Through Measuring Plasma endotoxin level the role of endotoxiemia in burn patients and the relationship between it and clinical appearances as well as treating methods were discussed. Methods:Thirty-three patients were randomly selected with an average BSA of 48.5% and Ⅲ° 14.7%. Venous blood samples were periodically collected and endotoxin level were quantitatively measared by limulus test. Results:The incidence of endotoxiemia (>40ng/L) were 92/192 (48%), which psitively relates to the full thickness burn area as well as body temperature and negatively relates to the percentage of neutrophils. The endotoxin levels reached to peaks again in 3 extreme extensively burned patients (BSA>80%, Ⅲ°>50% ) 40～50 days postburn. Conclusion: Many factors may influence clinical endotoxiemia and its subseqent responses were much complicated. Therefore clinical value of which needs further investigation.[