早期不同蛋白补充量对重症肺炎患者预后的影响  

Effect of different protein in early stage supplementation on prognosis of patients with severe pneumonia

作　　者：任轲[1] 林金锋[1] 王亚东[1] 韩旭东[1] REN Ke;LIN Jinfeng;WANG Yadong;HAN Xudong(Department of Critical Medicine,Nantong Third People's Hospital,Nantong,Jiangsu,226000,China)

机构地区：[1]南通市第三人民医院重症医学科,江苏南通226000

出　　处：《临床急诊杂志》2023年第4期185-189,共5页Journal of Clinical Emergency

摘　　要：目的:探讨早期不同蛋白摄入量对重症肺炎患者预后的影响。方法:回顾性分析诊断为重症肺炎的患者共94例,根据患者入ICU后28 d生存情况分为生存组和死亡组,收集统计2组患者的基线资料、实验室指标、临床资料等,并计算2组患者入院72 h内平均蛋白补充量,并根据蛋白补充量分为低蛋白组(<1.2 g/kg/d)和高蛋白组(≥1.2 g/kg/d)。比较不同蛋白组患者的并发症发生率及预后情况。统计采用Cox回归分析以及Kaplane-Meier生存曲线分析。结果:死亡组患者蛋白补充≥1.2 g/kg/d的患者例数明显少于生存组(χ^(2)=2.667,P=0.008);Cox回归分析显示蛋白补充量(≥1.2 g/kg/d)与显著降低病死率相关(HR=0.342,P=0.022);通过生存曲线分析显示≥1.2 g/kg/d的高蛋白组生存时间明显长于低蛋白组(χ^(2)=4.805,P=0.028);高蛋白组并发ARDS和脓毒性休克的发生率低于低蛋白组(P<0.05);另外与低蛋白组比较,高蛋白组可以缩短ICU住院时间(t=3.189,P=0.002),并降低28 d内病死率(χ^(2)=6.665,P=0.010)。结论:对于重症肺炎患者早期蛋白补充≥1.2 g/kg/d有利于改善患者病情并降低病死率。Objective To investigate the effects of different protein intake in early stage on the prognosis of patients with severe pneumonia.Methods A total of 94 patients diagnosed with severe pneumonia were retrospectively analyzed and divided into survival group and death group according to their 28-day survival.Baseline data,laboratory indicators and clinical information of the two groups of patients were collected and statistically analyzed,and the average protein supplementation of the two groups within 72 h after admission was calculated.They were divided into low protein group(<1.2 g/kg/d)and high protein group(≥1.2 g/kg/d).Complications and prognosis of patients with different protein groups were compared.Cox regression analysis and Kaplane-Meier survival curve analysis were used.Results The number of patients with protein supplement≥1.2 g/kg/d in the death group was significantly lower than that in the survival group(χ^(2)=2.667,P=0.008).Cox regression analysis showed that protein supplementation(≥1.2 g/kg/d)was associated with significantly lower mortality(HR=0.342,P=0.022).Survival curve analysis showed that the survival time of high protein group≥1.2 g/kg/d was significantly longer than that of control group(χ^(2)=4.805,P=0.028).The incidences of ARDS and septic shock in high protein group were lower than those in low protein group(P<0.05).The high protein group had shorter length of ICU stay(t=3.189,P=0.002)and lower mortality within 28 days(χ^(2)=6.665,P=0.010)compared with the low protein group.Conclusion Early protein supplementation≥1.2 g/kg/d is beneficial to reduce mortality and improve prognosis in patients with severe pneumonia.

关 键 词：蛋白补充 重症肺炎 预后 

分 类 号：R563.1[医药卫生—呼吸系统]