摘要
目的:探讨血浆循环DNA水平在酸、碱化学烧伤患者病情诊断中的临床应用意义。方法:随机选择宜昌市第二人民医院2014年6月至2018年4月收治的61例酸、碱化学烧伤患者,其中酸化学烧伤30例,碱化学烧伤31例。收集患者临床病理资料,并分别检测患者于烧伤后1,5,10,15,30,60 d血浆循环DNA水平和血常规指标。结果:患者血浆循环DNA水平在伤后第1天即高出正常水平(25 ng/mL);在伤后第5天,患者血浆循环DNA水平达到峰值,其中酸、碱化学烧伤患者中分别为(245.38±56.47)和(402.89±85.56) ng/mL;此后,患者血浆循环DNA水平均出现下降趋势,在伤后第60天,血浆循环DNA水平已接近正常水平。酸、碱化学烧伤患者血浆循环DNA水平与患者年龄、性别比、烧伤部位、白细胞数和单核细胞绝对值均无相关性(P>0.05);与平均烧伤面积、伤后至入院时间、烧伤指数、深Ⅱ度烧伤面积、Ⅲ度烧伤面积、入院前自救、红细胞比积、血红蛋白以及过氧化物酶活性指数呈正相关(P<0.05);与浅Ⅱ度烧伤面积呈负相关(P<0.05);此外,碱化学烧伤患者血浆循环DNA水平与红细胞数呈明显正相关(P<0.05),而酸化学烧伤患者血浆循环DNA水平与红细胞数无相关性(P>0.05)。结论:血浆循环DNA在酸、碱化学烧伤病情判断方面具有重要的临床应用价值,可作为酸、碱化学烧伤临床救治的诊断指标。
Objective: To explore the clinical significance of circulating DNA in diagnosis of acid and alkaline chemical burn. Methods: Sixty-one patients burned by acid or alkaline, including 30 cases of acid burn and 31 cases of alkaline burn, were randomly collected from June 2014 to April 2018 in Second People’s Hospital of Yichang. The clinicopathological data were collected, and the circulating DNA levels and blood routine indexes were measured respectively on Day 1, 5, 10, 15, 30 and 60 after burn. Results: The circulating DNA level was higher than normal level(25 ng/mL) on the 1 st day after burn(25 ng/mL). On the 5 th day after burn, the circulating DNA level reached the peak, and the acid and alkaline burns were(245.38±56.47) and(402.89±85.56) ng/mL, respectively. Then, the circulating DNA level of the patients showed a downward trend, and on the 60 th day after burn, the plasma circulating DNA level was close to the normal level. The circulating DNA level was no significant relationship with the age, sex ratio, burn site, white blood cell number and the absolute value of monocytes(P>0.05);while, positive relationship with the burn area, interval between burn and hospital treatment, burn index, deep Ⅱ degree burn area, Ⅲ degree burn area, self-rescue before admission, hematocrit, hemoglobin and peroxidase activity(P<0.05);however, negative relationship with shallow Ⅱ degree burn area(P<0.05). In addition, the circulating DNA level was significantly positively correlated with RBC count in patients with alkaline burns(P<0.05), while, circulating DNA level was not correlated with RBC count in patients with acid burn(P>0.05). Conclusion: The circulating DNA level can be used in progression evaluation of acid and alkaline chemical burn, as well as used as a diagnosis parameter in treatment of acid and alkaline chemical burnt patients.
作者
姚卫
YAO Wei(Department of lCU,Second People's Hospital of Yichang,Yichang Hubei 443000,China)
出处
《临床与病理杂志》
2018年第11期2402-2408,共7页
Journal of Clinical and Pathological Research
关键词
酸化学烧伤
碱化学烧伤
循环DNA
血常规指标
病情进展
acid chemical burn
alkaline chemical burn
circulating DNA
routine blood parameter
disease progression
