摘要
目的 探讨严重烧伤后多器官功能障碍综合征 (multipleorgandysfunctionsyndrome ,MODS)患者血清新喋呤的变化规律及预警价值。 方法 烧伤面积大于 70 % (70 %～ 10 0 % )的患者2 9例 ,按是否并发MODS分组 ,并参照Goris等提出的计分法对MODS进行评分。采用放射免疫分析法检测患者血清新喋呤含量的动态变化 ,并计算新喋呤诊断MODS的有效性和实用性。 结果严重烧伤后第 3、7、14和 2 1天 ,MODS组血清新喋呤水平明显高于非MODS组 (P <0 0 5～ 0 0 1)。相关分析显示 ,伤后第 3、7、2 1天MODS患者新喋呤含量与MODS积分值呈显著正相关 (r =0 470～ 0 811)。根据血清新喋呤的预警阈值 (35 0nmol/L) ,其诊断MODS的敏感性、特异性、阳性预测值和阴性预测值分别为 81 1%、89 9%、81 1%和 89 9%。 结论 循环新喋呤的持续和显著升高 ,与严重烧伤后MODS的发生与发展密切相关 。
Objective To evaluate the predictive value of serum neopterin for multiple organ dysfunction syndrome (MODS) in extensively burned patients. Methods Twenty nine burn patients with TBSA of more than 70% were included in this study, and these patients were divided into two groups according to the occurrence of MODS. Blood samples were obtained on 1, 3, 7, 14, 21 and 28 postburn days(PBDs). And serum neopterin levels were determined by radioimmunossay. To evaluate the predictive power of neopterin, sensitivity, specificity, predictive value of a positive/negative test were calculated for the diagnosis of MODS. Results Serum neopterin levels in MODS group were significantly higher than those in non MODS group on 3, 7, 14 and 21 PBDs (P<0 05~0 01). And a positive correlation was found between neopterin levels and MODS scores in patients who developed MODS on 3, 7 and 21 PBDs (r=0 470 ~ 0 811). In a period of up to 28 PBDs, neopterin levels exceeding 35 0 nmol/L were associated with MODS by a clinical sensitivity of 81 1%, a specificity of 89 9%, a positive predictive value of 81 1%, and a negative predictive value of 89 9%. Conclusion These data indicated that the presence of constant high neopterin serum levels appear to be associated with the development of postburn MODS. Serum levels of neopterin might be a useful marker for the early identification of extensive burned patients at risk for MODS. [
出处
《中华烧伤杂志》
CAS
CSCD
2001年第3期142-145,共4页
Chinese Journal of Burns
基金
国家重点基础发展规划项目 (G19990 5 42 0 3)
国家自然科学基金 ( 39870 2 86 )
军队杰出中青年人才专项基金 ( 98J0 13)资助项目
