高压氧治疗对严重烧伤患者血中sIL-2R和Fn含量变化的影响  

Effects of hyperbaric oxygen therapy on the changes in serum sIL-2R and Fn in severe burn patients

作　　者：徐能武[1] 李治才[1] 骆晓梅 孙曙光 程大胜 

机构地区：[1]解放军第九十七医院南京军区烧伤外科专科中心,徐州221004

出　　处：《中华整形烧伤外科杂志》1999年第3期220-223,共4页

摘　　要：目的通过观察高压氧治疗(Hyperbaric Oxygen Therapy,HBOT)对烧伤患者血中可溶性白介素2受体(Soluble interleukin-2 receptor,sIL-2R)及纤维连接蛋白(Fibronectin,Fn)含量的影响,探讨 HBOT 防治烧伤感染的价值。方法选择42例严重烧伤患者(烧伤面积>30%或Ⅲ度面积>10%),随机分为 HBOT 组(25例)和非 HBOT 组(17例),另选40名健康献血员作正常对照组。于伤后8h 及1,2,3,5,7,10,14,17,21,28,35天采集静脉血,ELISA 法测定血清 sIL-2R,火箭免疫电泳法测定其血浆 Fn,同时观察两组患者脓毒症发生率。结果非 HBOT 组:与正常对照组相比,伤后各时相点血清 sIL-2R 水平显著升高,而血浆 Fn 含量明显降低(P<0.05或 P<0.01);HBOT 组:与正常对照组相比,除伤后21天外,其余各时相点血清 sIL-2R 升高不明显;除伤后8h外,其余各时点血浆 Fn 降低不明显(P>0.05)。但与非 HBOT 组相比,伤后各时相点血清 sIL-2R均显著降低,而血浆 Fn 则明显增高(P<0.05或 P<0.01);与此同时,脓毒症发生率亦明显降低(P<0.05)。结论 HBOT 可显著降低严重烧伤患者血清 sIL-2R,而明显增高血浆 Fn,故对防治烧伤感染可能有益。Objective Many reports showed that level of soluble interleukin 2 receptor(sIL-2R)in sera was obviously increased in burn patients,while plasma fibronectin(Fn)was markedly decreased,and they had close relation with the occurrence and development of burn infection.The purpose of this study was to verify the significance of hyperbaric oxygen therapy(HBOT)in the prevention and treatment of burn infections by observing its effect on the levels of serum sIL-2R and Fn in severe burn patients.Meth- ods Forty two burn patients(with more than 30% body surface area or three degree more than 10%) were selected and divided into two groups at random:HBOT group(25 cases)and non-HBOT group(17 cases);forty healthy blood donors were selected as normal control.The venous blood samples were drawn from 42 patients at 1/3,1,2,3,5,7,10,14,17,21,28 and 35 days postburn,the levels of serum sIL-2R and Fn were measured by ELISA and rocket electrophoresis techniques respectively,meanwhile,the inci- dences of sepsis of two groups were compared.Results ①In non-HBOT group:the levels of serum sIL- 2R were remarkably increased,while serum Fn were markedly decreased at all periods postburn(compared with normal control:P<0.05 or P<0.01);②In HBOT group:the levels of serum sIL-2R were not ob- viously increased at all periods except 21 days postburn,and Fn were not decreased at all periods except 8h postburn(compared with normal control:P>0.05).Compared with non-HBOT group,however,the levels of serum sIL-2R were profoundly reduced,while Fn was significantly enhanced at all periods postburn(P <0.05 or P<0.01),and the incidence of sepsis was obviously lowered(P<0.05).Conclusion HBOT can significantly reduce the level of serum sIL-2R but enhance Fn in severe burn patients,so it may have a positive effect on the prevention and treatment of burn infections.

关 键 词：高压氧 烧伤 纤维连接蛋白 SIL-2R 

分 类 号：R644.05[医药卫生—外科学]