Erstad B L, Campbell D J, Rollins C J, Rappaport W D
Department of Pharmacy Practice, College of Pharmacy, University of Arizona, Tucson 85721.
Pharmacotherapy. 1994 Jul-Aug;14(4):458-62.
This prospective, nonrandomized study was conducted to compare the increases in albumin and prealbumin concentrations in postoperative patients given adequate nutrition support. All surgery patients at least 18 years of age and who required parenteral nutrition were included. Of 86 patients evaluated, 16 met all criteria for study entry. Blood for albumin concentrations was drawn within 48 hours of beginning parenteral nutrition and then weekly. Blood for prealbumin concentrations was drawn within 48 hours of beginning parenteral nutrition and then twice weekly. Albumin concentrations increased from 2.00 +/- 0.35 to 2.21 +/- 0.42 g/dl (NS). Prealbumin concentrations increased from 11.97 +/- 6.31 to 17.29 +/- 8.93 mg/dl (p = 0.017). All but one prealbumin concentration was in the normal range for our laboratory when parenteral nutrition was discontinued. None of the albumin concentrations were ever in the normal range. The prealbumin concentration is a better indicator than albumin of nutrition status in the postoperative patient. Since prealbumin concentrations typically rise into the normal range within a week after adequate caloric supplementation, clinicians may avoid unnecessary increases in protein-calorie intake and laboratory testing of nutrition status by using this measurement.
本前瞻性、非随机研究旨在比较给予充分营养支持的术后患者白蛋白和前白蛋白浓度的升高情况。纳入所有年龄至少18岁且需要肠外营养的手术患者。在评估的86例患者中，16例符合研究入选的所有标准。在开始肠外营养后48小时内采集白蛋白浓度血样，随后每周采集一次。在开始肠外营养后48小时内采集前白蛋白浓度血样，随后每周采集两次。白蛋白浓度从2.00±0.35g/dl升高至2.21±0.42g/dl（无统计学意义）。前白蛋白浓度从11.97±6.31mg/dl升高至17.29±8.93mg/dl（p = 0.017）。停止肠外营养时，除1例外，所有前白蛋白浓度均在我们实验室的正常范围内。白蛋白浓度均未处于正常范围内。在前瞻性患者中，前白蛋白浓度比白蛋白更能反映营养状况。由于在前瞻性补充足够热量后，前白蛋白浓度通常会在一周内升至正常范围，临床医生可通过使用该指标避免不必要地增加蛋白质热量摄入和营养状况的实验室检测。
