CysC和PA的联合检测对烧伤后多脏器损伤的意义

The significance of combined detection of Cys C and PA in multiple organ injuries after burns

目的观察胱抑素(CysC)和前白蛋白(PA)联合检测在烧伤患者早期肝、肾功能损害的临床价值。方法选取既往无肝、肾病史烧伤患者158例,根据烧伤面积及休克复苏情况分为中重度烧伤组、特重烧伤及时复苏组(<6 h)、特重烧伤延迟复苏组(≥6 h)和65例体检健康人群作为对照组。比较各组血清中ALT、AST、PA、Cys C、BUN、Cr的浓度。结果与健康对照组比较各烧伤组检测的ALT、AST、BUN和Cr的浓度都随烧伤严重程度而增加,但只在延迟复苏组中才与其他3组呈显著性改变;而血清Cys C和PA浓度,随着烧伤程度的加重从及时复苏组就有明显变化,并且随复苏时间的延长而变化显著,差异均有统计学意义(P<0.05)。结论烧伤患者血清Cys C和PA的浓度与烧伤程度、烧伤休克复苏时间呈相关性;二者在早期肝、肾损伤的检测指标中也最为敏感;对于重度烧伤引起的多脏器损害的早期诊断有重要的临床意义。

Objective To study the clinical value of combined detection of Cystatin C（Cys C） and Prealbumin（PA） in the early liver and renal function impairment of burn patients. Methods 158 burn patients without liver or kidney disease history were selected and divided into moderate and severe burn group,severe burn timely resuscitation group（6 h）,severe burn delayed resuscitation group（≥6 h）,according to the area of burn and the extent of shock resuscitation,and 65 healthy subjects as the control group. The concentrations of ALT,AST,PA,Cys C,BUN and Cr in serum were compared. Results Compared with the healthy control group,the concentrations of ALT,AST,BUN and Cr in the burn group increased with the severity of the burn,but they were significantly different from the other three groups only in the delayed resuscitation group. The concentration of serum Cys C and PA increased significantly with the degree of burn beginning from the timely resuscitation group,and changed significantly with the prolongation of recovery time,the differences were statistically significant（P0.05）. Conclusion The concentrations of serum Cys C and PA in burn patients were correlated with the degree of burn and resuscitation time of burn shock. They were also the most sensitive in the early liver and kidney damage tests. It is of important clinical significance for early diagnosis of multiple organ damage caused by severe burns.