严重烧伤病人血浆 D-二聚体与血栓调节蛋白及游离蛋白 S水平动态观察及相关性分析  

作　　者：谭文锋[1] 杨宗城[1] 王甲汉[1] 彭毅志[1] 彭代智[1] 罗奇志[1] 余 斌[1] 黎 鳌[1] 

机构地区：[1]第三军医大学附属西南医院烧伤研究所

出　　处：《第三军医大学学报》1999年第8期547-549,共3页Journal of Third Military Medical University

基　　金：国家自然科学基金

摘　　要：目的：探讨血管内皮细胞损伤对烧伤后 Ｄ Ｉ Ｃ 形成的影响。方法：选择４０％ ～５０％ Ｔ Ｂ Ｓ Ａ，深度烧伤面积大于２０％ ，１８～４５ 岁的男性病人１０ 例，以健康成年男性献血者（ｎ＝ １０）为对照，测定伤后１、３、５、７ ｄ血浆血栓调节蛋白，游离蛋白 Ｓ及 Ｄ二聚体抗原水平的变化。结果：伤后１、３、５、７ ｄ 血栓调节蛋白及 Ｄ二聚体血浆水平持续升高，且二者显著正相关。血浆游离蛋白 Ｓ伤后第１ 天显著下降，而后虽逐渐回升，至伤后第７ 天仍低于正常，且与 Ｄ二聚体血浆水平呈显著负相关。结论：严重烧伤后病人血浆 Ｄ二聚体与血栓调节蛋白水平显著正相关，与游离蛋白 Ｓ水平显著负相关。结果提示严重烧伤导致血管内皮细胞损伤及蛋白 Ｃ 抗凝途径的作用减弱是伤后 Ｄ Ｉ Ｃ 形成的重要原因。Observation on and correlative analysis of changes in plasm a levels of D┐dim er,throm bom odulin and free protein Sin severely burnt patients Tan Wenfeng, Yang Zongcheng, Wang Jiahan, Peng Yizhi, Peng Daizhi, Luo Qizhi, Yu Bin, Li Ao ( Research Institute of Burns, Southw est Hospital, Third Military Medical University, Chongqing, 400038)　　 Abstract　 Objective: To explore the effects of vascular endothelial celldam age on postburn D I C developm ent in severely burnt patients. Methods: The plasm a antigen levels of throm bom odulin, free protein Sand Ddim er w ere determ ine on the 1st, 3rd, 5th and 7th day follow ing injury in 10 patients (18～45 yearsold) suffered from 40～50% T B S A fullthickness skin burns. Ten healthy m ale volunteers w ere selected asthe controls. Results: The plasm a levels of throm bom odulin and Ddim er w ere persistently increased on the1st, 3rd, 5th and 7th day postburn and there w as significantly positive correlation betw een these tw o. Theplasm a leveloffree protein Sw as decreased on the 1stday, then gradually increased and stilllow er than thatin the controls on the 7th day postburn. It w as negatively correlated to that of Ddim er. Conclusion: Endothelialcelldam age and dim inution of the effects of protein C anticoagulant pathw ay are im portant reasonsfor D I C developm ent follow ing burns.　　

关 键 词：烧伤 血栓调节蛋白 D-二聚体 蛋白S 

分 类 号：R644[医药卫生—外科学]