创伤患者血清免疫球蛋白、补体和C-反应蛋白的变化  

Changes in serum immunoglobulins,complements and C-reactive protein in trauma patients

作　　者：李国平[1] 陶少宇[1] 郭斌[1] 

机构地区：[1]江西医学院第二附属医院急诊外科,江西南昌330006

出　　处：《中国危重病急救医学》2000年第2期99-100,共2页Chinese Critical Care Medicine

摘　　要：目的：探讨创伤患者免疫功能的变化及临床意义。方法：３０ 例创伤术后患者分为创伤组及创伤并发症组，分别在术后第１、７ 及１４ 日测定外周血清免疫球蛋白ＩｇＧ、ＩｇＡ、ＩｇＭ，补体Ｃ３ 、Ｃ４ 及Ｃ 反应蛋白（ＣＲＰ），并与正常对照组进行对比分析。结果：创伤组及创伤并发症组的免疫球蛋白、补体均在术后第１ 日明显降低，而ＣＲＰ明显升高（Ｐ均＜ ０．０５）。创伤组在术后第７ 日免疫球蛋白、补体及ＣＲＰ均基本恢复正常（Ｐ均＞ ０．０５）；而创伤并发症组在术后第７ 日ＩｇＧ、ＩｇＡ仍明显低于正常，而ＣＰＲ更为升高（Ｐ均＜ ０．０１）。在术后第１４日创伤组免疫球蛋白及补体均明显高于正常（Ｐ均＜ ０．０１），而创伤并发症组免疫球蛋白稍高于正常；ＣＲＰ下降接近正常。结论：创伤后早期免疫功能处于抑制状态，动态观察免疫球蛋白、补体及ＣＲＰ在血清中的变化可作为创伤患者病情观察的客观指标。Objective:To investigate the clinical significance of changes in immune functions in trauma patients.Methods:30 trauma patients were divided into trauma group and trauma complication group.Serum concentrations of IgG,IgA,IgM,complement 3 (C 3),complement 4 (C 4) and Creactive protein (CRP) were determined on days 1,7 and 14 after operation and the results were compared with normal control group.Results:IgG,IgA,IgM,C 3 and C 4 decreased whereas CRP markedly increased in both trauma group and trauma complication group on day 1 after operation (all P <0 05).IgG,IgA,IgM,C 3 and C 4 returned to normal range and CRP tended to approach normal values in trauma group on day 7 after operation (all P >0 05).However,IgG,IgA,C 3 and C 4 were still significantly low whereas CRP was even much higher in trauma complication group on day 7 after operation(all P <0 01),IgG,IgA,IgM,C 3 and C 4 were markedly increased in trauma group (all P <0 01) while IgG,IgA,IgM and C 4 were slightly higher in trauma complication group on day 14 after operation.Conclusions:These data suggest that humoral immune function was suppressed during early phase after trauma.The kinetic changes in IgG,IgA,IgM,C 3,C 4 and CRP might be used as parameters to evaluate the general state of trauma patients.

关 键 词：创伤 免疫功能 免疫球蛋白 补体 C-反应蛋白 

分 类 号：R641[医药卫生—外科学]