严重烧伤患者血脂变化与感染关系的研究

目的探讨严重烧伤患者血脂变化特点与感染并发症的关系。方法40例伤后24 h内入院的18～59岁严重热力烧伤患者,于入院时和伤后1、2、3、5、7、14、21 d空腹采血样本,检测血清总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A1（apoA1）、甘油三酯（TG）水平,并监测感染并发症和预后情况。以40例健康体检者作为对照组。结果40例患者中有21例发生感染37例次,感染发生率52.5%。与对照组比较,患者伤后1 d脂蛋白已明显降低（P〈0.01）,伤后3～7 d TC、HDL、apoA1、LDL降至最低水平,其中以HDL降幅最大。在伤后2～21 d,感染者的HDL、apoA1水平明显低于非感染者（P〈0.01）。结论患者烧伤后TC、HDL、apoA1、LDL降低,HDL水平降低与感染有关。

The study of serum lipids changes in patients with severe burns and its relations with infectious complications

Objective To investigate the changes of serum lipids in patients with severe burns and its relations with infectious complications. Methods Forty patients with thermal severe injuries aged from 18 to 59 years admitted within 24 hours, and blood samples were drawn on admission and postburn day 1,2,3,5,7,14 and 21. Serum total cholesterol （TC）, high-density lipoproteins （HDL） ,lowdensity lipoproteins （LDL）, apolipoprotein A1 （apoA1）,and triglyceride （TG） were measured in all patients and compared with those of 40 volunteers. The infectious complications and outcome were monitored. Results In 40 patients, a total of 37 identifiable infection episodes occurred in 21 patients （52.5%）. The concentrations of serum lipoproteins in patients decreased significantly on day 1, lower than those of the controls （P〈0. 01）, and reached a nadir in day 3 to day 7, especially HDL. From day 2 to day 21, HDL and apoA1 levels in infection patients were lower than those in non-infection patients （P〈0. 01）. Conclusion The concentrations of serum TC, HDL, apoA1,and LDL decreased in severe burn patients,and lower HDL levels might be related to the infectious complications.