尿α_1—微球蛋白监测在烧伤临床治疗中的意义

The significance of monitoring of urinary 1microglobulin in the treatment of burn injury

目的探讨尿中α１—微球蛋白（α１—ＭＧ）与烧伤病人肾功能的关系及其对烧伤治疗的指导作用。方法３６例病例分成５组：正常对照组（Ａ）、轻度烧伤组（Ｂ）、中度烧伤组（Ｃ）、重度烧伤组（Ｄ）、特重烧伤组（Ｅ）。采用放免法测定各组病例在规定时相的尿α１—ＭＧ、尿β２—微球蛋白（β２－ＭＧ），尿白蛋白（Ａｌｂ）及血ＢＵＮ、血Ｃｒ，各指标分别制表，进行组间和指标间对照分析。结果烧伤程度加重，尿α１—ＭＧ、尿β２—ＭＧ、尿ＡＩｂ的测得值随之加大，特重烧伤组与正常对照组比较均有显著性差别（Ｐ＜０．０１）；在特重烧伤早期尿α１—ＭＧ，尿β２—ＭＧ出现异常时，血ＢＵＮ、血Ｃｒ表现正常；尿α１－ＭＧ值监测效果表现最为稳定。结论尿α１—ＭＧ测定具有早期监测肾功能的价值。其简便，可靠、灵敏，可作为早期常规检测项目以指导治疗；血尿素氮，血肌酐不灵敏，不能早期反映肾功能改变。

Objective To explorc the relation between urinary 1-microglobulin(1-MG) and renal function after burn injury. Methods 36 Cases were divided into five groups: normal group(A). minor burn (B), moderate burn (C), major burn (D), the most severe burn(E). Urinary 1-MG, 2-MG, Alb and Serum BUN. and Cr were determined regularly with radioimmunoassay(RIA). All data were made chart and compared among the groups. Results The more degree of burn increases ,the more urinary 1-MG,2_MG and A1b do. There are statistically significant difference (P<0.01) in all values between group E and group A; Serum BUN and Cr are normal when urinary 1-MG and 2-MG are abnormal during early times of the most severe burn; The monitoring effect of urinary 1-MG is most steady. Conclusions It is shown that monitoring of urinary 1-MG were valuable to detect the early changes of renal function after burn injury. Since this method is simple, reliable and sensitive, it should be regarded as a early routine test in order to guid the treatment of burn injury. The monitoring effect of serum BUN and Cr and relatively insensitive.