Carlson D E, Cioffi W G, Mason A D, McManus W F, Pruitt B A
US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-5012.
JPEN J Parenter Enteral Nutr. 1991 Jul-Aug;15(4):440-4. doi: 10.1177/0148607191015004440.
The use of serum visceral protein concentrations as predictors of nitrogen balance was assessed during the first 4 weeks following thermal injury. The correlation between nitrogen balance and serum albumin was not significant. Statistically significant correlations were found between nitrogen balance and serum prealbumin, retinol-binding protein, and transferrin. However, even the best correlation (retinol-binding protein, r = 0.388) was too weak to permit prediction of nitrogen balance on the basis of the visceral protein concentration. The correlation between change in direction of nitrogen balance and change in direction of protein concentration over time showed all four visceral proteins to be poor predictors of change in nitrogen balance. The efficiency was less than 50% for each visceral protein. Stepwise multiple regression analysis performed to determine which indices were most closely correlated with nitrogen balance showed that a calculation using readily available information (nitrogen intake, postburn day, percent total body surface burned, and age) provided better prediction of nitrogen balance (r = 0.765) than any of the visceral protein concentrations. In view of these findings, measurement of serum visceral protein concentrations to monitor adequacy of nutritional support seems an unwarranted expense in patients with thermal injury.
在热损伤后的前4周内，评估了血清内脏蛋白浓度作为氮平衡预测指标的作用。氮平衡与血清白蛋白之间的相关性不显著。氮平衡与血清前白蛋白、视黄醇结合蛋白和转铁蛋白之间存在统计学上的显著相关性。然而，即使是最佳相关性（视黄醇结合蛋白，r = 0.388）也很弱，无法根据内脏蛋白浓度预测氮平衡。氮平衡方向的变化与蛋白质浓度随时间的变化方向之间的相关性表明，所有四种内脏蛋白都是氮平衡变化的不良预测指标。每种内脏蛋白的效率均低于50%。为确定哪些指标与氮平衡最密切相关而进行的逐步多元回归分析表明，使用现成信息（氮摄入量、烧伤后天数、全身烧伤百分比和年龄）进行的计算比任何内脏蛋白浓度都能更好地预测氮平衡（r = 0.765）。鉴于这些发现，对于热损伤患者，测量血清内脏蛋白浓度以监测营养支持是否充足似乎是一项不必要的开支。
