汶川地震93例挤压综合征患者实验室检测结果
摘要
目的分析地震所致挤压综合征(CS)患者的实验室检测结果,为临床治疗提供帮助。方法测定93例CS患者反映肝功能、肾功能和电解质平衡的指标,进行尿液化学成分和沉渣分析、血液细胞分析。结果(1)电解质紊乱,K(5.98±1.28)mmol/L、P(2.23±0.50)mmol/L升高,Na(128.1±10.05)mmol/L、Cl(89.2±10.49)mmol/L、Ca(1.82±0.24)mmol/L]降低。(2)肾功能受损,Ure(30.54±9.10)mmol/L、Cr(448±284)μmol/L、UA(525±192)μmol/L、CysC(5.11±1.45)mg/L明显升高,尿中出现大量RBC(=765个/μl)、WBC(=163个/μl),尿蛋白定性皆阳性(1+～3+)。(3)ALT(455±437)U/L、AST(1039±1000)U/L、LDH(2672±1853)U/L明显升高,ChE(3760±1284)U/L、Alb(26.94±4.18)g/L明显降低,提示肝功能损害。(4)RBC(3.29×1012)±(0.73×1012)/L、Hb(95±19.7)g/L、HCT0.289±0.060降低,MCV(88.4±4.37)fl、MCH(29.1±1.39)pg、MCHC(329±8.9)g/L正常,显示为正常细胞性贫血;PLT(97±62)×109/L出现不同程度的降低;(3.29±0.73)×1012/L WBC(13.28±5.78)×109/L升高。透析患者(n=22)血清CysC和LDH高于未透析患者(n=71)CsyC:(5.70±1.01)mg/L vs(3.91±1.60)mg/L,P=0.025;LDH:3340 U/L(987～6725)U/L vs 1634 U/L(481～3434)U/L,P=0.002,差异有显著性意义。其余指标在透析者和未透析者之间的差异无统计学意义(P>0.05)。结论挤压综合征患者实验室检测指标提示多器官功能损害或衰竭。
引文
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[3]Sever MS,Vanholder R,Lameire N,et al.Management of crush-related injuries after disasters[J].N Engl J Med,2006,354(3):1052-1063.
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[5]Yeun J Y,Hasbargen J A.Renal hypouricemia:prevention of exer-cise-induced acute renal faiure and a reviewof the literature[J].Am J Kidney Dis,1995,25(6):937-946.
[6]Hously D G,Eccles R,Richards R J.Gender difference in the con-centration of the antioxidant uric acid in human nasal lavage[J].Ac-ta Otolaryngol Stockh,1996,116(5):751-754.
[7]Sever MS,Erek E,Vanholder R,et al.Serum potassium in the crush syndrome victims of the Marmara disaster[J].Clin Nephrol,2003,59(5):326-333.
[8]吴在德.外科学[M].第5版.北京:人民卫生出版社,2002.55-56.
[9]Vanholder R,Sever M S,Erek E,et al.Rhabdomyolysis[J].J Am Soc Nephrol,2000,11(8):1553-1561.
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