Lim Seung Hui, Lee Jong Seok, Chae Sang Hee, Ahn Bo Sook, Chang Dong Jin, Shin Cheung Soo
Department of Pharmacy, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-gu, Seoul 135-720, Korea.
Yonsei Med J. 2005 Feb 28;46(1):21-6. doi: 10.3349/ymj.2005.46.1.21.
It was reported that 30-50% of inpatients are in a malnutrition status. Measuring the prealbumin level is a sensitive and cost-effective method for assessing the severity of illness in critically or chronically ill patients. However it is uncertain whether or not the prealbumin level correlates with the level of nutrition support and outcomes in critically ill patients. The aim of this study was to evaluate serum prealbumin level as an indicator of the effectiveness of nutrition support and the prognosis in critically ill patients. Forty-four patients who received total parenteral nutrition for more than 7 days at an intensive care unit (ICU) were studied. The serum prealbumin was measured at the initial time of nutrition support and at the almost seventh day since the first measurement. The patients were allocated into two groups. In Group 1 (n=31) and 2 (n=13), the prealbumin level increased and decreased, respectively. Age, APACHE II score, nutrition status, nutritional requirement and amount of supply, mortality, hospital day and ICU day in the two groups were compared. The serum prealbumin level increased in 31 out of the 44 patients. The average calorie intake was 1334 Kcal/day (83% of energy requirement) in Group 1 and 1170 kcal/day (76% of energy requirement) in Group 2 (p=0.131). The mortality was 42% in Group 1 and 54% in Group 2 (p=0.673). The average hospital day/ ICU day in Groups 1 and 2 were 80 days/38 days and 60 days/31 days respectively. In conclusion, in critically ill patients, the serum prealbumin level did not respond sensitively to nutritional support. In addition an increase in the prealbumin level dose not indicate a better prognosis for critically ill patients.
据报道，30%-50%的住院患者处于营养不良状态。测定前白蛋白水平是评估危重症或慢性病患者病情严重程度的一种敏感且经济有效的方法。然而，前白蛋白水平与危重症患者的营养支持水平及预后是否相关尚不确定。本研究的目的是评估血清前白蛋白水平作为危重症患者营养支持效果及预后的指标。对在重症监护病房（ICU）接受全胃肠外营养超过7天的44例患者进行了研究。在营养支持开始时及首次测量后近第7天测定血清前白蛋白。将患者分为两组。第1组（n=31）和第2组（n=13）的前白蛋白水平分别升高和降低。比较两组患者的年龄、急性生理与慢性健康状况评分系统（APACHE II）评分、营养状况、营养需求及供给量、死亡率、住院天数和ICU住院天数。44例患者中有31例血清前白蛋白水平升高。第1组的平均热量摄入量为1334千卡/天（占能量需求的83%），第2组为1170千卡/天（占能量需求的76%）（p=0.131）。第1组的死亡率为42%，第2组为54%（p=0.673）。第1组和第2组的平均住院天数/ICU住院天数分别为80天/38天和60天/31天。总之，在危重症患者中，血清前白蛋白水平对营养支持反应不敏感。此外，前白蛋白水平升高并不表明危重症患者预后更好。
