新喋呤与内毒素对烧伤后多器官功能障碍综合征的诊断价值

目的：探讨循环新喋呤与内毒素对严重烧伤后多器官功能障碍综合征（Ｍｕｌｔｉｐｌｅｏｒｇａｎｄｙｓｆｕｎｃｔｉｏｎｓｙｎｄｒｏｍｅ，ＭＯＤＳ）的诊断价值；方法：对４７例烧伤面积（ＴＢＳＡ）大于３０％（３０％～１００％）患者血清新喋呤、血浆内毒素水平的变化进行动态观察。分别计算新喋呤、内毒素、新喋呤合并内毒素诊断多器官功能障碍综合征（ＭＯＤＳ）的敏感性、特异性及准确性等。结果：根据新喋呤、内毒素对ＭＯＤＳ的预警阈值（３５．０ｎｍｏｌ／Ｌ和５００ＥＵ／Ｌ），新喋呤合并内毒素诊断ＭＯＤＳ的敏感性、特异性及准确性分别为８８．３％、９３．７％、９１．６％，均明显高于单独应用新喋呤或内毒素。结论：动态同步观察循环新喋呤和内毒素水平的变化，对于严重烧伤后ＭＯＤＳ的早期诊断与病程监测具有一定的临床价值。

Neopterin and Endotoxin for Diagnosis of Multiple Organ Dysfunction Syndrome in Patients with Extensive Burns

o evaluate the diagnostic value of neopterin and endotoxin for multiple organ dysfunction syndrome(MODS) in patients with extensive burns. Methods: This prospective study included 47 patients with burn size greater than 30%, and 22 healthy volunteers who served as a control group. Blood samples were obtained on 1,3,7,14,21, and 28 days postburn and serum neopterin and plasma endotoxin levels were measured by using commercially available test kits. To evaluate the predictive power of the used parameter, sensitivity, specificity or accuracy was calculated for diagnosis of MODS. Results: In a period of up to 28 days postburn, values of neopterin and endotoxin exceeding 350 nmol/L and 500 EU/L were associated with MODS by a clinical sensitivity of 883%, a specificity of 937%, and an accuracy of 916%, showing a significant predictive value of these two variables in diagnosis of MODS. Conclusions:Neopterin and endotoxin might be useful parameters for the early diagnosis of MODS and monitoring of the clinical course in patients with major burns.