监护室重症患儿的营养状态分析  

Nutritional status of children in pediatric intensive care unit

作　　者：李洁[1] 蒋璐[1] 苏基逸[1] 董小燕[1] 

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院,上海200040

出　　处：《中国妇幼健康研究》2012年第1期84-86,89,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的 评价儿科重症监护室重症患儿营养状态,为合理实施营养支持提供依据.方法 随机抽取上海市儿童医院儿科重症监护室重症住院患儿的临床相关资料,测定其体重及血清白蛋白、转铁白蛋白、前白蛋白、血红蛋白、红细胞压积、平均红细胞体积、红细胞分布宽度、淋巴细胞绝对值、免疫球蛋白（IgG、IgA、IgM）、T细胞亚群（CD3、CD4、CD8、CD4/CD8）百分比并进行分析.结果 在154例重症患儿中,27.8%体重低于正常儿童年龄别体重第10百分位（P10）;20.1%血浆白蛋白水平偏低、31.4%前白蛋白和转铁白蛋白指标偏低;转铁白蛋白和前白蛋白的水平与体重显著相关（r值分别为0.429和0.377,P〈0.05）;34.4%血红蛋白水平低下,36.7%红细胞压积降低、48.9%平均红细胞体积降低;血红蛋白水平与红细胞分布宽度呈现较强的负相关（r=-0.329,P〈0.05）.22.2%淋巴细胞绝对值指标偏高,10.0%免疫球蛋白指标偏高,15.6%T细胞亚群指标偏低.淋巴细胞绝对值与CD4、CD4/CD8均显著正相关（r值分别为0.431和0.551,P〈0.05）;与CD3呈负相关（r=-0.375,P〈0.05）.结论 重症患儿中存在不同程度的低体重、低血浆蛋白、贫血、免疫功能异常等营养问题.在治疗时应重视和加强营养支持,以提高患儿的营养状态及治疗效果.Objective To estimate the nutritional status of severe children patients in pediatric intensive care unit （PICU） and to provide evidence for implementing nutrition support reasonably. Methods The data of 154 randomly selected children with different age, gender and disease in PICU of Shanghai Children＇ s Hospital was analyzed. Their weight, levels of serum albumin, transferrin, prealbumin, hemoglobin, hematocrit, mean corpuscular volume, red cell distribution width, absolute value of lymphocyte, immunoglobin （ IgG, IgA, IgM） and T cell subsets （ CD3, CD4, CD8, CD4/CDs ） were determined and analyzed. Results Among 154 children 27.8% were low weight and weight for age was 10 percent ,20.1% of the children had lower plasma-albumin level and 31.4% had lower prealbumin and transferrin level. The levels of transferrin and prealbumin were significantly related with weight （ r value was 0. 429 and 0. 377, respectively, both P 〈0.05 ）. There were 34.4% children having low level of hemoglobin, 36.7% having low hematocrit and 48.9% having low level of mean corpuscular volume. The level of hemoglobin was negatively related with red cell distribution width （ r = - 0.329, P 〈 0.05 ）. 22.2% of the children had high level of absolute value of lymphocyte, 10.0% had high level of IG, but 15.6% had low level of T cell subsets. The absolute value of lymphocyte was positively related with CD4 and CD4/CDs （ r value was 0. 431 and 0. 551, respectively, both P 〈 0.05）, but negatively related with CD3 （ r = - 0. 375, P 〈 0.05 ）. Conclusion Nutritional diseases such as low weight, low plasma protein, anemia and abnormal immune functions of different degree exist in severe patients. Nutrition support should be highly considered and strengthened in treatment so as to improve children＇ s nutritional status and therapeutic efficacy.

关 键 词：重症患儿 营养 免疫 体重 T细胞亚群 

分 类 号：R174[医药卫生—妇幼卫生保健]