目的 探讨对烧伤患者检测血清降钙素原(procalcitonin,PCT)和尿肾损伤分子1(kidney injury molecule 1,KIM-1)的临床意义。方法 选择2013-01至2013-12在我院烧伤科住院的烧伤患者123例,依据烧伤程度将其分为轻、中、重度烧伤组,每组41例,选取同期在我院行健康体检的者40名作为对照组,比较各组一般体征(体温、心率、呼吸)、白细胞计数(WBC)、C反应蛋白(CRP)、尿素氮(BUN)、胱抑素C(Cys-C)、PCT和KIM-1水平。结果 与健康对照组比较,轻中重度烧伤组体温、心率、呼吸差异无统计学意义(P＞0.05);WBC水平轻中重度烧伤组与健康对照组比较差异有统计学意义(11.5±2.7、12.7±3.3、17.9±5.6,P＜0.05),但轻与中度烧伤组差异无统计学意义(P＞0.05)重度烧伤组与轻中度烧伤组有统计学意义(P＜0.05);CRP水平轻中重度烧伤组与健康组比较差异有统计学意义(P＜0.05),但是3组烧伤组比较差异无统计学意义(P＞0.05);BUN测定只有重度烧伤组与其余各组比较差异有统计学意义(P＜0.05);Cys-C水平中重度烧伤组与健康对照组比较差异有统计学意义(P＜0.05);与健康组比较,烧伤组的PCT、KIM-1水平比较差异均有统计学意义(P＜0.05);不同程度烧伤组间比较(轻中、中重、轻重度),PCT、KIM-1水平比较差异均有统计学意义(P＜0.05)。结论 血清降钙素原和尿肾损伤分子1可用于烧伤患者不同程度的检测,值得临床推广应用。

Objective To study the meaning of serum PCT and urine KIM-1 detection for urine kidney damage in patients with different degree burns. Methods 123 burn patients admitted from January - December 2013 in this hospital were divided intomild, medium and severe burn groups. 40 subjects andergoing physical examination during the same period in this hospital were selected as controls. Generally signs (body temperature, heart rate, breathing), CRP, BUN, Cys-C, PCT and KIM - 1 levels were compared between the two groups. Results Compared with healthy control group, mild-to-severe burn group had no significant difference in terms of body temperature, heart rate and respiration (P＞0.05). Mild-to-severe burn group, compared to healthy group, had statistically significant difference in WBC levels (11.5±2.7,12.7±3.3,17.9±5.6,P＜0.05), but had no remarkable difference compared with mild-to-moderate burn group that the severe burn group and mild-to-moderate burn group havd statistically significant difference. The CRP level in mild-to-severe burn group had obvious difference compared with healthy group (P＜0.05) while no obvious difference among the three burn groups (P＞0.05). As to BUN measurement, only severe burn group had difference with other groups (P＜0.05). The difference in the Cys-C levels in moderate-to-severe burn group compared with healthy group had statistically significant differcace (P＜0.05). All differences in terms in PCT and KIM-1 levels of burn groups compared with healthy group had statistically significant difference. And the differences in PCT and KIM-1 levels among different burn groups (mild-to-moderate, moderate-to-severe, mild-to-severe) had statistically significant difference (P＜0.05). Conclusions The serum PCT and KIM-1 can be used in different degree burn patients with sepsis in the early detection, which is of great significance.