CAJ | 학술논문

目的：探讨血清同型半胱氨酸(HCY)、胱抑素C(CysC)及尿微量白蛋白(mAlb)在重度烧伤患者中含量的变化及其临床意义。方法选取既往无肾病史烧伤患者110例,根据烧伤面积( BSA)分轻中度烧伤组、重度烧伤及时复苏组(4小时内复苏)、重度烧伤延迟复苏组(>4小时复苏)及52例体检健康人群作为对照组。采用循环酶法测定HCY,两点终点法测定CysC,免疫比浊法测定尿mAlb。结果重度烧伤及时复苏组血清内HCY、Cys-C和mAlb含量明显高于对照组和轻中度烧伤组,而重度烧伤延迟复苏组内HCY、CysC和mAlb含量分别是及时复苏组1.3倍、2.1倍和1.8倍,差异有显著性。同时三项指标联合检测的敏感性明显高于单项指标检测。结论 HCY、CysC 和尿mAlb可作为早期诊断重度烧伤引起的肾损伤较敏感的指标；联合检测能大大提高检测阳性率,在诊断重度烧伤引起早期肾损伤中具有显著的临床意义。
목적：탐토혈청동형반광안산(HCY)、광억소C(CysC)급뇨미량백단백(mAlb)재중도소상환자중함량적변화급기림상의의。방법선취기왕무신병사소상환자110례,근거소상면적( BSA)분경중도소상조、중도소상급시복소조(4소시내복소)、중도소상연지복소조(>4소시복소)급52례체검건강인군작위대조조。채용순배매법측정HCY,량점종점법측정CysC,면역비탁법측정뇨mAlb。결과중도소상급시복소조혈청내HCY、Cys-C화mAlb함량명현고우대조조화경중도소상조,이중도소상연지복소조내HCY、CysC화mAlb함량분별시급시복소조1.3배、2.1배화1.8배,차이유현저성。동시삼항지표연합검측적민감성명현고우단항지표검측。결론 HCY、CysC 화뇨mAlb가작위조기진단중도소상인기적신손상교민감적지표；연합검측능대대제고검측양성솔,재진단중도소상인기조기신손상중구유현저적림상의의。
Objective To explore the diagnostic significance of the joint detection of serum homocysteine (HCY), Cystatin C ( Cys-C ) and urinary microalbuminuria ( mALB ) in early renal damage triggered by severe burn. Method According to burn surface area,110 burn patients without kidney disease are divided into slight-moderate group (33 patients),instant recovery group (38 patients)or delayed recovery groups(40 patients). 52 healthy vol-unteers were enrolled as control group. The levels of homocysteine were determined by enzymatic cycle method, while contents of Cystatin C were determined by two-point end assay, and microalbuminuria was sxexamined with immunoturbidimetric assay. Result The levels of HCY, Cys-C and mALB significantly increased in severe burn and instant recovery group compared to control group and slight-moderate group. The amounts of HCY, Cys-C and mALB in severe burn and delayed recovery group were 1. 3, 2. 1, and 1. 8 times of those in instant recovery group, respectively. The sensitivity of joint detection of these 3 indexes in diagnosis of early rental damage are obviously improved compared to single index detection. Conclusion HCY, Cys-C and mALB can act as sensitive indicators to diagnose early rental damage caused by severe burn. Combined detection can greatly increase the sensitivity, which is important in monitoring the occurrence of early nephropathy caused by severe burn.