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一种新型基于底物的荧光白蛋白检测方法可改善接受护理营养干预的血液透析患者的临床结局评估。

A Novel Substrate-Inspired Fluorescence-Based Albumin Detection Improves Assessment of Clinical Outcomes in Hemodialysis Patients Receiving a Nursing Nutrition Intervention.

机构信息

Blood Purification Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).

出版信息

Med Sci Monit. 2021 Aug 10;27:e930257. doi: 10.12659/MSM.930257.

Abstract

BACKGROUND Albumin level does not precisely reflect nutritional status. We aimed to investigate the impact of a nutrition intervention on hemodialysis patients by use of fluorescence-based plasma albumin (FPA) detection. MATERIAL AND METHODS Eighty patients underwent maintenance hemodialysis for more than half a year and had a mean albumin <3.5 g/dL for over 3 months. The subjects were randomly divided into either a Control Group (CG) or an Intervention Group (IG). The IG received nutritional supplementation, and the CG group received routine nutritional support for 12 months. FPA and plasma albumin (PA) concentrations were measured. The fluorescence probe 1,3-Dichloro-7-hydroxy-9,9-dimethyl-2(9H)-acridone methyl biphenyl benzoate was used in FPA detection. Quality of life was estimated using WHOQOL-BREF (Quality of Life Scale developed through the World Health Organization), the 36-Item Short-Form Survey (SF-36), and the 6-minute walking test (6MWT). RESULTS After a 6-month and a 12-month intervention, PA and FPA concentrations increased, and the increase in FPA concentration was higher than that of PA in the IG group (P<0.05). Comparatively, the parameters of quality of life and 6MWT were improved in the IG group (P<0.05) but there were only minor changes in the CG group (P>0.05). There is an obvious association between the changes in FPA concentration and the parameters of quality of life and 6MWT but not PA. CONCLUSIONS Use of the fluorescence probe improves the detection sensitivity of plasma albumin and provides a potential method to assess clinical outcomes in hemodialysis patients.

摘要

背景

白蛋白水平不能准确反映营养状况。我们旨在通过使用基于荧光的血浆白蛋白(FPA)检测来研究营养干预对血液透析患者的影响。

材料和方法

80 名接受维持性血液透析治疗半年以上且白蛋白均值<3.5g/dL 超过 3 个月的患者被纳入研究。将患者随机分为对照组(CG)和干预组(IG)。IG 接受营养补充,CG 组接受常规营养支持 12 个月。测量 FPA 和血浆白蛋白(PA)浓度。荧光探针 1,3-二氯-7-羟基-9,9-二甲基-2(9H)-吖啶酮甲基联苯苯甲酸用于 FPA 检测。使用 WHOQOL-BREF(世界卫生组织开发的生活质量量表)、SF-36(36 项简短健康调查)和 6 分钟步行测试(6MWT)评估生活质量。

结果

干预 6 个月和 12 个月后,PA 和 FPA 浓度增加,IG 组 FPA 浓度增加高于 PA(P<0.05)。相比之下,IG 组的生活质量和 6MWT 等参数有所改善(P<0.05),但 CG 组仅有微小变化(P>0.05)。FPA 浓度的变化与生活质量和 6MWT 等参数之间存在明显关联,但与 PA 无关。

结论

荧光探针的使用提高了血浆白蛋白的检测灵敏度,为评估血液透析患者的临床结局提供了一种潜在方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/713e/8364288/e8781da147c2/medscimonit-27-e930257-g001.jpg

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