蛋白质充足达标时间对危重症机械通气患者预后的影响  

Effect of time to achieve sufficient protein on the prognosis of critically ill patients using mechanical ventilation

作　　者：朱小茜 岳向峰 黄学敏 刘秋红[4] 吕全军 ZHU Xiaoxi;YUE Xiangfeng;HUANG Xuemin;LIU Qiuhong;LYU Quanjun(Department of Nutrition and Food Hygiene,College of Public Health,Zhengzhou University,Zhengzhou 450001;Department of Pharmacy,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Zhengzhou Erqi District Center for Disease Control and Prevention,Zhengzhou 450015;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Nutrition,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学公共卫生学院营养与食品卫生学教研室,郑州450001 [2]郑州大学第一附属医院药学部,郑州450052 [3]郑州市二七区疾病预防控制中心,郑州450015 [4]郑州大学第一附属医院呼吸与重症医学科,郑州450052 [5]郑州大学第一附属医院营养科,郑州450052

出　　处：《郑州大学学报（医学版）》2024年第4期560-563,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：达能营养中心膳食营养研究与宣教基金优先资助项目(DIC2022-01)。

摘　　要：目的:探讨蛋白质充足达标时间对使用机械通气的危重症患者预后的影响。方法:选择2020年12月至2021年10月郑州大学第一附属医院ICU收治,入住时间>3 d且使用机械通气的危重症成年患者377例,按入住ICU后蛋白质充足达标时间分为早期(1~2 d)组93例,中期(3~7 d)组155例,晚期(>7 d)组129例。比较3组预后,并采用Cox回归分析蛋白质充足达标时间对患者入住ICU 60 d内死亡的影响。结果:与早期组和晚期组相比,中期组患者的院内死亡率最低(P=0.002)。Cox回归结果显示调整混杂因素后,以晚期为对照,蛋白质充足中期达标是危重症机械通气患者入住ICU 60 d内死亡的保护因素(HR=0.675,95%CI:0.456~0.997)。结论:蛋白质充足3~7 d达标对危重症机械通气患者的预后具有积极影响。Aim:To investigate the effect of time to achieve sufficient protein on the prognosis of critically ill patients using mechanical ventilation.Methods:A total of 377 critically ill adult patients admitted to the ICU of the First Affiliated Hospital of Zhengzhou University from December 2020 to October 2021,with a length of stay>72 hours and using mechanical ventilation,were selected and allocated into early group of 93 patients(1-2 days),middle group of 155 patients(3-7 days),and late group of 129 patients(>7 days),according to time to achieve sufficient protein.The prognosis of the 3 groups was compared,and Cox regression was used to analyze the impact of time to achieve sufficient protein on death within 60 days.Results:Compared with the early group and the late group,the middle group had the lowest in-hospital mortality(P=0.002).Cox regression showed that after adjusting for confounders,using the late group as control,achieving sufficient protein within 3-7 days was a protective factor against death within 60 days in mechanically ventilated critically ill patients(HR=0.675,95%CI:0.456~0.997).Conclusion:Achieving sufficient protein within 3-7 days has a positive impact on the prognosis of mechanically ventilated critically ill patients.

关 键 词：危重症 机械通气 蛋白质充足 

分 类 号：R459.3[医药卫生—治疗学]