论文部分内容阅读
目的：通过对危重症患者血清组织释放酶及蛋白酶抑制物活性的监测，评价其与脏器衰竭之相关性。方法：对７０例危重症患者按ＭＯＦ的诊断标准分为Ａ组（１个脏器衰竭），Ｂ组（２个脏器衰竭），Ｃ组（３个脏器衰竭），测定ＡＣＰ、ＣＫ、ＣＫ－ＭＢ、ＬＤＨ、ＡＳＴ及α－ＡＴ的活性，观察与正常对照组的变化。Ａ组与Ｂ组ＭＯＦ患者加测入院后立即、８ｈ、１２ｈ、２４ｈ酶活性，了解其演变规律。结果：危重病人组织释放酶不同程度升高，显著高于对照组（Ｐ＜００１），而且与脏器衰竭的数目呈明显相关性；α－ＡＴ早期下降，１２ｈ略有回升；脏器衰竭越多，下降趋势显著（Ｐ＜００１）。结论：组织释放酶参与危重病人应激状态的病理生理过程；α－ＡＴ下降与组织释放酶二者之间的平衡早期遭到破坏是导致全身反应和组织破坏的一个重要原因。观察其动态含量，有利于ＭＯＦ的诊断治疗，可能是判断患者预后的重要因素。
OBJECTIVE: To evaluate the correlation between serum creatinine and protease inhibitor activity in critically ill patients and organ failure. Methods: Seventy critically ill patients were divided into group A (one organ failure), group B (two organ failure) and group C (three organ failure) according to MOF diagnostic criteria. ACP, CK, CK-MB, LDH, AST and α-AT activity were observed with the normal control group changes. A group and B group MOF patients measured after admission immediately, 8h, 12h, 24h enzyme activity, to understand its evolution. Results: The release of enzymes in critically ill patients increased to different extents, which was significantly higher than that of the control group (P <001), but also significantly correlated with the number of organ failure. Α-AT decreased in the early stage and rose slightly after 12 hours. The more failure, a significant downward trend (P <0 01). CONCLUSION: Tissue release enzymes are involved in the pathophysiological process of stress state in critically ill patients. The early destruction of the balance between the reduction of α-AT and the release of tissue-releasing enzymes is an important cause of systemic reactions and tissue destruction. Observation of its dynamic content is conducive to the diagnosis and treatment of MOF may be an important factor in determining the prognosis of patients.