Nguyen Lam N, Phan Khanh Q, Nguyen An H
National Burn Hospital Hanoi, Viet Nam.
Medical Military University Viet Nam.
Int J Burns Trauma. 2020 Aug 15;10(4):107-112. eCollection 2020.
The aims of this study were to determine characteristics and factors influencing metabolic hormones including serum catecholamines, cortisol level and liver size in severe adult burn patients. A prospective study was conducted on 44 adult burn patients with burn extent from and over 20% TBSA admitted during 72 h after burn to burn intensive care unit, National Burn Hospital, Vietnam. Serum levels of epinephrine, norepinephrine and cortisol were measured on admission and 7 day after burn. Liver size was measured by ultrasound on admission and 21 day after burn. The results indicated that norepinephrine level did not significantly change along the time meanwhile epinephrine concentration significantly increased after 1 week (P < 0.01). Serum cortisol level was higher than normal physiological value and then significantly reduced at 7 day post burn (P < 0.05). Significantly increased liver size was seen at the 21 day postburn (P < 0.01). Age, gender, burn severity, inhalation injury and death did not affect concentration of catecholamines and liver size. Meanwhile, cortisol level was significantly higher in patients with deep burn area ≥ 20% TBSA at 7 day after burn and in non-survivors (P < 0.05). Further studies are necessary to understand clearly metabolic state in severe adult burn patients.
本研究的目的是确定影响成年重度烧伤患者代谢激素的特征和因素，这些激素包括血清儿茶酚胺、皮质醇水平和肝脏大小。对越南国家烧伤医院烧伤重症监护病房收治的44例烧伤面积达20%及以上总体表面积（TBSA）的成年烧伤患者进行了一项前瞻性研究。在入院时和烧伤后7天测量血清肾上腺素、去甲肾上腺素和皮质醇水平。在入院时和烧伤后21天通过超声测量肝脏大小。结果表明，去甲肾上腺素水平随时间无显著变化，而肾上腺素浓度在1周后显著升高（P < 0.01）。血清皮质醇水平高于正常生理值，然后在烧伤后7天显著降低（P < 0.05）。烧伤后21天可见肝脏大小显著增加（P < 0.01）。年龄、性别、烧伤严重程度、吸入性损伤和死亡情况不影响儿茶酚胺浓度和肝脏大小。同时，烧伤后7天深度烧伤面积≥20%TBSA的患者和非存活患者的皮质醇水平显著更高（P < 0.05）。有必要进行进一步研究以清楚了解成年重度烧伤患者的代谢状态。
