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目的:探究烧伤患者血浆胰岛素样生长因子结合蛋白-1(IGFBP-1)水平的变化及其临床意义。方法:选择2013年1月-2015年1月我院收治的70例烧伤患者作为研究组,依据总体表烧伤面积(TBSA)将患者分为4个亚组:Ⅰ组(1%~15%)34例、Ⅱ组(16%~30%)9例、Ⅲ组(31%~50%)17例、Ⅳ组(51%~95%)10例;选取同期于我院体检健康者50例作为对照组。测定研究者IGFBP-1、胰岛素样生长因子(IGF-1)水平,分析其与TBSA的相关性。结果:在10d观察期内,Ⅲ组和Ⅳ组患者的IGF-1水平均显著低于对照组(P<0.05),而Ⅱ组患者IGF-1水平仅在烧伤后1 d时与对照组存在差异(P<0.05),且在烧伤后2 d,随着分级的增加,血浆IGF-1水平有下降的趋势,组间差异具有统计学意义(P<0.05);研究组患者的IGFBP-1水平均显著高于对照组(P<0.05);随着分级的增加,血浆IGFBP-1有上升的趋势,组间差异具有统计学意义(P<0.05);线性相关性分析显示,烧伤患者血浆IGF-1水平与TBSA值呈负相关(r=-0.693,P<0.05);血浆IGFBP-1水平与TBSA值呈正相关(r=0.377,P<0.05)。结论:烧伤患者血浆IGF-1水平显著下降,而IGFBP-1水平则显著升高,与烧伤严重程度密切相关,二者可作为判断烧伤患者预后的重要预警指标。
Objective: To investigate the changes of plasma insulin-like growth factor binding protein-1 (IGFBP-1) in burn patients and its clinical significance. Methods: Seventy burn patients admitted to our hospital from January 2013 to January 2015 were selected as the study group. The patients were divided into four subgroups according to the total surface burn area (TBSA): group Ⅰ (1% -15%), (N = 34), group Ⅱ (16% ~ 30%), group Ⅲ (17% ~ 50%), group Ⅲ and group Ⅳ (51% ~ 95% Control group. The level of IGFBP-1 and insulin-like growth factor (IGF-1) were determined and their correlation with TBSA was analyzed. Results: During the 10-day observation period, the levels of IGF-1 in group Ⅲ and group Ⅳ were significantly lower than those in control group (P <0.05), while the level of IGF-1 in group Ⅱ was only found at 1 d after burn (P <0.05). At 2 days after burn, plasma IGF-1 level decreased with the increase of grade, and there was a significant difference between two groups (P <0.05). IGFBP-1 (P <0.05). The level of plasma IGFBP-1 increased with the increase of grade, the difference was statistically significant (P <0.05). The linear correlation analysis showed that the plasma level of plasma The level of IGF-1 was negatively correlated with TBSA (r = -0.693, P <0.05). The level of plasma IGFBP-1 was positively correlated with TBSA (r = 0.377, P <0.05). Conclusion: The plasma IGF-1 level in burn patients decreased significantly, while the level of IGFBP-1 increased significantly, which is closely related to the severity of burn. Both of them may be used as an important index to predict the prognosis of burn patients.