观察前白蛋白在危重症患者营养支持和临床结局中的作用  

Observing Prealbumin's Impact on Nutrition Support and Clinical Outcomes for Critical Ill Patients

作　　者：李素芬[1] 陆祖娥[1] 易华[1] 胡长玉[1] 唐晓珍[1] 

机构地区：[1]广西桂林医学院附属医院,广西桂林541001

出　　处：《临床医药文献电子杂志》2015年第21期4296-4297,共2页Electronic Journal of Clinical Medical Literature

基　　金：桂林市科学研究与技术开发计划课题(项目编号:20120121-1-6);广西自然科学基金课题(2013GXNSFAA278004);广西壮族自治区卫生厅计划课题(项目编号:Z2012450)

摘　　要：目的评价血清前白蛋白(PA)水平作为危重症患者营养支持效果和临床结局指标的应用价值。方法选择入住重症监护室(ICU)急性生理学及慢性健康状况评分系统(APACHEⅡ)≥8分的80例危重症患者,依据营养支持24 h前PA在120 mg/L上下分为两组,各40例,选择肠内+早期肠外营养支持方案,监测两组营养支持3天及7天后的PA及白蛋白(ALB)的变化,并对两组患者的营养支持效果及临床结局进行比较。结果两组患者的营养支持效果和临床结局比较,差异均无统计学意义(P>0.05)。结论对危重症患者而言,PA不适合作为单独的营养指标来反映危重症患者的营养状况,而PA水平降低并不是影响危重症患者临床结局的独立危险因素。Objective To evaluate the value of serum prealbumin（PA） level as an indicator of nutritional support and clinical outcome for critically ill patients. Methods 80 cases of critically ill patients who stayed in the intensive care unit（ICU） and whose acute physiology and chronic health evaluation system（APACHE Ⅱ） is larger than 8 points have been selected. Based on the nutrition support before 24 hours, all the cases are divided into two groups, each 40 cases. One group of cases is above 120 mg/L while the other group is below 120 mg/L. And each group is 40 cases. Enteral and early parenteral nutrition supports have been taken to monitor the change of PA and ALB 3 days and 7 days after the nutrition support with each group and compare the outcome of nutrition support and clinical outcome between two groups. Results There is no statistical difference（P〈0.05） between the nutrition support and clinical outcomes within 2 groups. Conclusion PA is not suitable as a sole nutrition indicator to show the nutritional status of critically ill patients. The decline of PA is not the sole risk factor that impact critically ill patients＇ clinical outcome.

关 键 词：危重症患者 前白蛋白(PA) 营养支持 临床结局 

分 类 号：R6[医药卫生—外科学]