摘要
病人受伤当日及伤后第3、7、14、21、27日查尿中β_2-微球蛋白(β_2-m),白蛋白(ALb),IgG,Tamm-Horsfall 糖蛋白(THP),发现烧伤面积30%～50%者 ALb 为正常2倍,IgG无变化.烧伤面积50%以上者。ALb 增加5倍,IgG 增加4倍.二者可以区别肾小球损伤程度。本组27例感染期β_2-m 均有增高,因为β_2-m 在近曲小管重吸收,故考虑该部位容易受损。THP 在中,重度烧伤呈增加趋势,特重度烧伤或肾功能衰竭时明显减少,可反映髓袢厚段升支部位受损情况.尿"四蛋白"与尿素氮、肌酐相比灵敏度高,能反映肾功能早期改变。
Urinary β_2-microglobulin,albumin,IgG,Tamm-Horsfall mucoprotein,and glycoprotein were determined on PBD 0,1,3,7,14,21,27.It was found that the amount of albumin was double that of normal in patients with burn extent of 30%～50% TBSA,while IgG showed no change.In patients with over 50% TBSA burns,Alb was five-fold and IgG four-fold of normal.They probably indicated the degree of damage to the glomeruli.In 27 patients with infection,β_2-m was increased,indicating damage to the proximal convoluted tubules.Glycoprotein showed a tendency to increase in moderate and severe burns,while it was mar edly reduced in very large burns or renal failure,indicating damage to the ascending limb of thick medullary loop.The changes in the amount of urinary protein were more sensitive in reflecting early functional changes of the kidney.
