白蛋白在ICU老年低白蛋白血症患者应用的评估  

作　　者：马海英[1] 申丽[1] 杜全胜[1] 王志刚[1] 赵鹤龄[1] 

机构地区：[1]河北省人民医院重症医学科,050051

出　　处：《当代医学》2011年第35期21-23,共3页Contemporary Medicine

摘　　要：目的评估重症监护病房中低白蛋白血症的老年危重症患者,输入白蛋白能否纠正低白蛋白血症,降低28天病死率。方法对2010年月～2011年6月期间河北省人民医院重症监护病房住院的65例老年低蛋白血症患者,记录基础血浆白蛋白浓度,计算APACHEII评分,实验组输入20%白蛋白10克,对照组不输入白蛋白,于第4、7、10、14、21、28天复查肝功能,记录白蛋白浓度,第28天病死率。两组患者视病情可酌情采用肠内或肠外营养,能量供给20～30kcal/d。结果 65例老年低白蛋白血症患者入选,32例实验组,33例对照组,两组之间病情危重程度无差异,实验组白蛋白浓度略低于对照组(21.48±2.09vs24.09±2.56,P值>0.05),28天后实验组白蛋白浓度明显升高(24.01±2.65vs21.48±2.09,P值<0.05),与入选时相比有统计学差异,但仍然并未能纠正低白蛋白血症。对照组白蛋白浓度也较入选时升高(26.78±2.02vs24.09±2.56,P值<0.05),28天后两组之间白蛋白浓度无统计学差异。两组之间病死率无统计学差异。结论重症监护病房老年低白蛋白血症患者每日输入白蛋白10克能升高患者血浆白蛋白浓度,但不能纠正低白蛋白血症,对于病死率无明显改善。Objective To analysis albumin adminisration in hypoalbuminemia patients in ICU. To learn whether albumin administration can improve hypoalbuminemia and reduce the mortality. Methods We enrolled 65 old hypoalbuminemia patients in critical care unit between January,2010 and June,2011. We detected the concentration of albumin and the score of acute physiology and chronic health evaluation II （APACHEII）.Then we administrated 10 gram albumin per day in albumin group and none in control group. After albumin administration, we detected the change of albumin the 4th day, 7th days, 10th day, 14th day, 21st day and 28th day. We recede the mortality on the 28th day. Two group of patients regarded the condition to be possible to use either parenteral or enteral nutrition, power supply 20- 30kcal/d. Results 65 old patients were enrolled, 32 patients in albumin group and 33 patients in control groups. The APACHEII were similar between the two groups. The concertration of albumin had no difference between the two groups （21.48＋2.09 vs 24.09q-2.56,P〉0.05 ）. After 28 days, there were elevation in the albumin group（24.01~2.65 vs21.48-4-2.09, P〈0.05） and had statistics significance. But it could not correct the hypoalbuminemia. There were also significant change in control group（26.78~2.02 vs 24.09-4-2.56, P〈0.05）. But there were no statistics difference between the two group.And there were no statistics difference on mortality between the two groups. Conclusion Administrated 10 gram albumin per day in old hypoalbuminemia patients could elevate the concentration of albumin. But it could not correct the hypoalbuminemia. There is no benefit of improving mortality.

关 键 词：低白蛋白血症 白蛋白 重症监护病房 危重病人 老年 

分 类 号：R459.7[医药卫生—急诊医学]