Gray G E, Meguid M M
Department of Surgery, University Hospital, SUNY Health Science Center, Syracuse 13210.
Nutrition. 1990 May-Jun;6(3):225-8.
To determine if hypoalbuminemia is a consequence of protein-energy malnutrition rather than an associated feature of cancer, we reviewed results when vigorous nutritional support was given to 13 men and 9 women who had solid tumors (head and neck [10], gastrointestinal [8], other [4]) and an initial serum albumin less than 3.5 g/dl. Patients had received a minimum of 21 days of nutritional support with total parenteral nutrition (TPN) supplying an average daily energy intake of at least 1.5 x basal energy expenditure (BEE). The TPN was started at a dosage commensurate with the patient's estimated postoperative caloric requirements, and patients had received an average of 2358 kcal/day (1.97 x BEE) and 1.54 g of protein/kg of body weight. Patient body weights increased by an average of 2.75 kg during the 21 days of TPN, but there was no statistically significant change in serum albumin, suggesting that factors other than malnutrition were primarily responsible for the hypoalbuminemia. Although TPN is useful as an adjunct in patients with cancer, it may not reverse the hypoalbuminemia commonly seen in this population.
为了确定低白蛋白血症是蛋白质 - 能量营养不良的结果而非癌症的相关特征，我们回顾了对13名男性和9名女性实体瘤患者（头颈部[10例]、胃肠道[8例]、其他[4例]）给予积极营养支持后的结果，这些患者初始血清白蛋白低于3.5g/dl。患者接受了至少21天的营养支持，采用全胃肠外营养（TPN），平均每日能量摄入量至少为基础能量消耗（BEE）的1.5倍。TPN起始剂量与患者预计的术后热量需求相称，患者平均每日摄入2358千卡（1.97×BEE）以及1.54克蛋白质/千克体重。在TPN的21天期间，患者体重平均增加2.75千克，但血清白蛋白无统计学显著变化，这表明除营养不良外的其他因素是低白蛋白血症的主要原因。虽然TPN对癌症患者是一种有用的辅助手段，但它可能无法逆转该人群中常见的低白蛋白血症。
