血清胆碱酯酶在大面积烧伤患者营养状态评价中的意义

目的 观察大面积烧伤患者血清胆碱酯酶活性变化，探讨其临床意义。方法 观察13例特重度大面积烧伤患者休克期（伤后第1天）、伤后第3天、伤后第5天、创面溶痂期（伤后第7天、10天）、异体皮排斥期（伤后第14天、21天、28天）、创面基本愈合期（伤后第45天）的血清胆碱酯酶活性、谷丙转氨酶含量、前白蛋白及白蛋白水平变化。结果 伤后第5天至异体皮排斥期，谷丙转氨酶含量异常增高。创面溶痂期及异体皮排斥期，血清胆碱酯酶活性明显降低，创面基本愈合后血清胆碱酯酶活性迅速恢复至正常水平。伤后第5天至创面溶痂期，前白蛋白含量明显降低；而白蛋白含量无明显改变。结论 血清胆碱酯酶是反映大面积烧伤患者肝脏合成蛋白质能力和机体营养状态的较好生化指标。

Significance of Serum Cholinesterase in Evaluating Nutritional Status of Severe Burn Patients

Objective To investigate the changes of activity of serum cholinesterase in severe burn patients and its clinical significance. Methods Thirteen severe burn patients were enrolled into this study. The changes of glutamic-pyruvic transaminase (GPT),albumin,pre-albumin,and activity of serum cholinesterase in severe burn patients were observed 1,3,5,7,10,14,21,28,and 45 days after injury. Results The GPT increased abnormally after injury from day 5 to day 28. The activity of serum cholinesterase decreased dramatically from day 7 to day 28,and returned rapidly to the normal levels as most of the wounds was healed. The pre-albumin also decreased from day 5 to day 14,while the albumin showed little changes in the whole course. Conclusion The activity of serum cholinesterase may be an important biochemical index to reflect the ability of protein synthesis of liver and nutritional status in severe burn patients.