动态监测血清铜蓝蛋白水平对MODS早期诊断及预后的评估意义

Dynamic monitoring of serum ceruloplasmin levels for early diagnosis and prognosis of MODS

目的:探讨血清中铜蓝蛋白动态变化对多器官功能障碍综合征(MODS)患者病因判断和预后评估的价值。方法:于入院当天分别检测60例MODS患者(MODS组)、30例非MODS患者(对照组)血清铜蓝蛋白(CP)、超敏C反应蛋白(CRCP)、α-酸性糖蛋白(AAG)及乳酸的含量,并对MODS组进行组内比较,入选的住院患者均进行急性生理和慢性健康评分(APACHEⅡ)和MODS评分;于第3、5、7天分别对MODS组患者进行血清CP、CRCP、AAG乳酸的含量进行测定,并行组内比较。结果:MODS组APACHEⅡ、MODS评分、CP、CRCP、AAG与对照组比较,差异具有统计学意义(P<0.05);无改善或恶化的MODS组患者,随着时间的推移,比较上述指标在各时间段的变化,差异均具有统计学意义(P<0.05)。结论:MODS患者CP、CRCP、AAG的检测有助于MODS早期诊断;随着病情的进展,铜蓝蛋白水平有不同程度的增高,有助于对MODS预后判断。

Objective： To investigate the value of dynamic change of serum ceruloplasmin in evalu- ating pathogenesis and predicting prognosis in patients with MODS. Method .. On the day of admission, detected serum ceruloplasmin （CP）, hypersensitive c-reactive protein （CRCP）, alpha acid glycoprotein （AAG） and the content of lactic acid in 60 patients with MODS （MODS group）, 30 cases of non-MODS patients （control group） and the MODS group, parameters of the MODS were compared within group. A- PACHE Ⅱ , MODS score and the detected parameters were compared between MODS group and control group. On the 3rd, 5th, and 7th day, serum ceruloplasmin （CP）, hypersensitive C-reactive protein （CRCP）, alpha acid glycoprotein （AAG） were determined and compared in the MODS group. Results： A-PACHE Ⅱ, MODS score, serum ceruloplasmin （CP）, hypersensitive c-reactive protein （CRCP）, the comparison of alpha acid glycoprotein （AAG） of the MODS group were significant different from that of the control group （P〈0.05）. For patients with no signs of improvement or deterioration, changes of the detected parameters were significant different at different time points （P〈0.05）. Oonclusion： For patients with MODS, CP, CRCP, AAG detection can help to diagnose early MODS, and High-sensitivity ceruloplasmin levels increase with progression of the disease indicating it＇s helpful for prognosis.