Spies C D, Kissner M, Neumann T, Blum S, Voigt C, Funk T, Runkel N, Pragst F
Department of Anaesthesiology and Operative Intensive Care Medicine, Benjamin Franklin Medical Centre, Free University of Berlin, Germany.
Alcohol Alcohol. 1998 Nov-Dec;33(6):661-9. doi: 10.1093/alcalc/33.6.661.
Carbohydrate-deficient transferrin (CDT) is reported to have a higher specificity in alcoholism than conventional markers. As the morbidity and mortality rates amongst chronic alcoholics are raised following trauma, the objective was to investigate if CDT could be used to predict prolonged intensive care unit (ICU) stay and an increased morbidity in patients with multiple injuries admitted to the ICU. In this prospective double-blind study, 66 traumatized male patients were transferred to the ICU following admission via the emergency room and operative management. Blood samples for CDT determination were taken upon admission to the emergency room, the ICU and on days 2 and 4 following admission. The patients were allocated a priori to two groups: high CDT group (CDT >20 U/l on admission to the emergency room) and low CDT group (CDT < or = 20 U/l). CDT values were determined by microanion-exchange chromatography and radioimmunoassay. Thirty-six patients had an elevated CDT value on admission to the emergency room. The high CDT group had a significantly prolonged ICU stay (median high CDT group: 13 davs; median low CDT group: 5 days). Major intercurrent complications, such as alcohol-withdrawal syndrome, tracheobronchitis, pneumonia, pancreatitis, sepsis, and congestive heart failure, were significantly increased in the high CDT group. The increased risk of pneumonia in the high CDT group may be related to the significantly increased period of mechanical ventilation. As high CDT values were associated with an increased risk of intercurrent complications and a prolonged ICU stay, it seems reasonable to use CDT as a marker in intensifying research work into preventing alcoholism-associated complications.
据报道，缺糖转铁蛋白（CDT）在酒精中毒方面比传统标志物具有更高的特异性。由于慢性酒精中毒患者在创伤后的发病率和死亡率会升高，因此目的是研究CDT是否可用于预测入住重症监护病房（ICU）的患者长时间住院以及多发伤患者发病率的增加。在这项前瞻性双盲研究中，66名受创伤的男性患者经急诊室入院并接受手术治疗后被转入ICU。在进入急诊室、ICU时以及入院后第2天和第4天采集用于测定CDT的血样。患者被预先分为两组：高CDT组（进入急诊室时CDT>20 U/l）和低CDT组（CDT≤20 U/l）。CDT值通过微阴离子交换色谱法和放射免疫测定法测定。36名患者在进入急诊室时CDT值升高。高CDT组的ICU住院时间明显延长（高CDT组中位数：13天；低CDT组中位数：5天）。高CDT组的主要并发并发症，如酒精戒断综合征、气管支气管炎、肺炎、胰腺炎、败血症和充血性心力衰竭，明显增加。高CDT组肺炎风险增加可能与机械通气时间明显延长有关。由于高CDT值与并发并发症风险增加和ICU住院时间延长相关，将CDT用作加强预防酒精中毒相关并发症研究工作的标志物似乎是合理的。
