中文摘要：

目的了解抗生素治疗过程中，严重烧伤患者血浆内毒素水平的变化。方法选择50例烧伤面积大于30％TBSA的患者，分别应用临床上常见抗生素[分为奈替米星、头孢哌酮、头孢他啶、亚胺培南／西司他丁（亚胺培南）组]常规治疗。采用偶氮基质显色法，检测抗生素治疗前后患者血浆内毒素水平。结果奈替米星、头孢哌酮和头孢他啶组患者给药后，血浆内毒素水平有不同程度升高。其中头孢哌酮组先升高后下降，用药后第1、2天明显高于第3、5、7天（P〈0．05），同时明显高于亚胺培南组（P〈0．05）。头孢他啶组用药后第5天内毒素水平达高峰（0．398±0．172）EU／mL，明显高于用药前[（0．251±0．142）EU／mL，P〈0．05]，也明显高于奈替米星组、头孢哌酮组和亚胺培南组（P〈0．05）。亚胺培南组用药后第1、2天血浆内毒素水平明显低于用药前。结论不同抗生素治疗严重烧伤患者可诱导不等量的内毒素释放，临床用药应注意药物本身对内毒素水平的影响。

英文摘要：

Objective To investigate the changes in the plasma levels of endotoxin in severe burn pa tients during administration of antibiotics. Methods Fifty severe burn patients with burn area larger than 30% TBSA were enrolled in the study, and they were respectively treated with Netilmicin （A group） , Cefoperazone（B group）, Ceftazidime（ C group） and lmipenem/Cilastatin（ D group）. Venous blood samples were harvested for determination of endotoxins levels before treatment and 1,2,3,5,7 post-treatment day （PTD） Results The plasma levels of endotoxin were elevated in different degrees in A, B and C groups. The plasma levels of endotoxin in B group were higher on 1,2 PTD than on 3,5,7 PTD ,and they were also higher than that in D group（ P 〈0.05）. The plasma levels of endotoxin in C group reached the peak on 5 PTD[ （0. 398 ±0. 172）EU/mL ] ,which were higher than that before treatment [ （0. 251 ±0. 142）EU/mL, P 〈 0.05 ] and other groups （ P 〈 0.05 ）. The plasma levels of endotoxin in D group were lower on 1,2 PTD than that before treatment（ P 〈 0.05 ）. Conclusion Different amounts of endotoxins can be released after treatment with antibiotics in severe burn patients. Attention should be paid to the effect of antibiotics on the levels of endotoxin in practice.