初步探索NICU患者血红蛋白和红细胞比容测定值与多蛋白水平的关系  

Preliminary exploration on the correlation between levels of hemoglobin/hematocrit and multi-proteins in the serum of NICU patients

作　　者：刘轩慧 王倩[1] 骆宏亮 安硕[1] 郭林月 田野[1] 魏盈胜[1] 孙健[1] 江荣才[1] LIU Xuan-hui;WANG Qian;LUO Hong-liang;AN Shuo;GUO Lin-yue;TIAN Ye;WEI Ying-sheng;SUN Jian;JIANG Rong-cai(Department of Neurosurgery and Tianjin Neurological Institute, General Hospital, Tianjin Medical University, Tianjin 300052,China)

机构地区：[1]天津医科大学总医院神经外科天津市神经病学研究所,天津300052

出　　处：《天津医科大学学报》2019年第2期128-131,共4页Journal of Tianjin Medical University

基　　金：国家自然科学基金资助项目(81671221);天津市科技支撑项目(14ZCZDSY00179);天津医科大学临床医学研究项目(2017kylc007)

摘　　要：目的:初步探索以神经外科重症监护病房(NICU)患者常见临床化验指标血红蛋白(HB)、红细胞比容(HCT)判断患者多种营养相关蛋白水平的可能性。方法:前瞻性纳入2017年8月-11月天津医科大学总医院NICU收治的急性脑损伤患者43例。采集入组第1天及第7天的血液标本并测评第7天APACHE II评分和SOFA评分,同步检测患者HB、HCT、白蛋白(ALB),前白蛋白(PA)和转铁蛋白(TR)水平,分析HB与HCT与ALB、PA、TR之间测定值及变化值的相关关系,以及HB、HCT分别与APACHE II评分和SOFA评分之间的相关关系。也记录同步检测的动脉血血气分析中HB和HCT值,分析它们与静脉血检测值相关关系。同时,对HB与HCT测定值之间相关关系也进行分析。结果:患者入组1 d和7 d的HB和HCT的测定值与同时间点ALB、PA和TR的测定值均呈正相关(r=0.521,P=0.000;r=0.306,P=0.004;r=0.420,P=0.000),且它们的变化值同样也呈正相关(r=0.581,P=0.000;r=0.496,P=0.001;r=0.527,P=0.000),同时HB、HCT与患者APACHE II评分和SOFA评分呈负相关(r=-0.735,P=0.000;r=-0.607,P=0.005)。HCT与HB实测值之间呈正相关(r=0.942,P=0.000),动静脉血所测得的HB/HCT值之间呈正相关(r=0.960,P=0.000;r=0.964,P=0.000)。结论:NICU临床常规检测的HB和HCT测定值可代表多蛋白水平,具有临床实用价值。Objective: To explore the relationship between the levels of multiple nutrition related proteins with common clinical test indexes of hemoglobin(HB) and hematocrit(HCT). Methods:A prospective study was conducted from August 2017 to November 2017. Forty-three inpatients who suffered from acute cerebral injury in the Neurosurgical Intensive Care Unit(NICU) in Tianjin Medical University General Hospital were enrolled. The blood samples were collected from each enrolled patients on day 1 and day 7 after they were admitted. Meanwhile, APACHE II score and SOFA score were assessed on day 7. The levels of HB, HCT, albumin(ALB), prealbumin(PA) and transferrin(TR) were all measured. Then the correlation analysis between these values and their trend were performed. Meanwhile HB/ HCT data of the arterial blood samples was recorded from the blood gas analysis results. The correlations between HB/HCT data of venous and arterial blood samples were also analyzed. At the same time,The correlation between HB and HCT was analyzed Results:There was a significant positive correlation between detection values of HB/HCT and values of Alb, PA and TR (r=0.521,P=0.000;r=0.306,P=0.004;r=0.420,P=0.000)on day 1 and on day 7 after admission. Changes in values were also significantly and positively correlated(r=0.581,P=0.000;r=0.496,P=0.001;r=0.527,P=0.000). Moreover,there were negative correlations between HB /HCT and APACHE II score and between HB/HCT and SOFA score respectively(r=-0.735,P =0.000;r=-0.607,P=0.005). Positive correlation between HCT and HB was showed(r=0.942,P=0.000).The HB/HCT data of venous was significantly positively correlated with that of arterial blood samples (r=0.960,P=0.000;r=0.964,P=0.000). Conclusion:The clinical routine testing results of HB or HCT in NICU may be used to indicate levels of multi-proteins of NICU patients, with significant clinical value in practice.

关 键 词：营养 蛋白 血红蛋白 红细胞比容 

分 类 号：R651.19[医药卫生—外科学]