Yang Z C
Burn Institute, Southwestern Hospital.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1992 Mar;8(1):8-12, 83.
51 burned patients with TBSA over 30% were studied prospectively. MOF developed in 17 of them. Postburn MOF occurred mainly in those with TBSA over 70%. Mortality of MOF was directly proportional to the number of organs involved. The incidence of pulmonary failure was the highest, and the highest mortality was attributed to renal failure. MOF occurring in the early stage was more related to burn shock, and those occurring in the late stage was predisposed mainly by infection. Oxygen free radicals play an important role in the genesis and development of postburn MOF. In this study, it was revealed that antiperoxidation ability declined, active oxygen was increased, and lipid peroxidation became excessive after the burn injury. It was also found that oxygen free radical-mediated effects produced more serious damages in patients with MOF than those without, and also more in those died than the survivors. The hypoxanthine-xanthine oxidase system was a significant source of oxygen radicals after the burn injury. There were also significant changes in plasma TXA2 and PGI2 levels postburn. The marked increase in TXA2/PGI2 ratio indicated imbalance between TXA2 and PGI2, which was correlated well with burn size and closely related to the development of postburn MOF. The excessive production of TXA2 might trigger or accelerate the formation of microaggregates and thromboxane, subsequently leading to visceral damages and failure.
对51例烧伤面积超过30%的患者进行了前瞻性研究。其中17例发生了多器官功能衰竭（MOF）。烧伤后MOF主要发生在烧伤面积超过70%的患者中。MOF的死亡率与受累器官的数量成正比。肺功能衰竭的发生率最高，而最高死亡率归因于肾功能衰竭。早期发生的MOF与烧伤休克关系更大，而晚期发生的MOF主要由感染诱发。氧自由基在烧伤后MOF的发生和发展中起重要作用。在本研究中发现，烧伤后抗氧化能力下降，活性氧增加，脂质过氧化过度。还发现，氧自由基介导的效应在MOF患者中比无MOF患者造成的损害更严重，在死亡患者中比存活患者更严重。次黄嘌呤-黄嘌呤氧化酶系统是烧伤后氧自由基的重要来源。烧伤后血浆血栓素A2（TXA2）和前列环素（PGI2）水平也有显著变化。TXA2/PGI2比值显著升高表明TXA2与PGI2之间失衡，这与烧伤面积密切相关，且与烧伤后MOF的发生密切相关。TXA2的过度产生可能触发或加速微聚集体和血栓素的形成，进而导致内脏损伤和功能衰竭。
