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目的 :探讨血清视黄醇结合蛋白(retinol binding protein,RBP)在危重患者营养支持效果评价中的意义。方法:2013年9月—2014年4月南京医科大学第一附属医院重症医学科68例ICU住院患者作为实验组,计算入院时及入院营养支持7 d后APACHEⅡ评分,测定入院时及行营养支持7 d后血清RBP、白蛋白、转铁蛋白及血红蛋白水平;65例门诊体检者为对照组。结果:实验组入院时血清RBP、白蛋白、转铁蛋白及血红蛋白水平明显低于对照组(P<0.001),经过7 d营养支持,血清RBP水平较入院时显著升高(P<0.001),转铁蛋白及血红蛋白较入院时升高(P<0.05),而白蛋白水平较入院时有所下降,但差异无统计学意义(P>0.05),血清RBP水平与APACHEⅡ评分呈显著负相关(P<0.01)。结论:血清RBP能够及时、准确地反映危重患者营养支持的效果,同时可以动态评估病情变化。
Objective: To investigate the significance of serum retinol binding protein (RBP) in assessing nutritional support in critically ill patients. Methods: From September 2013 to April 2014, 68 ICU inpatients in the Department of Critical Care Medicine of the First Affiliated Hospital of Nanjing Medical University were enrolled in the study. APACHEⅡscores were calculated at admission and 7 days after hospital admission. Nutritional support After 7 days, serum RBP, albumin, transferrin and hemoglobin levels were detected; 65 outpatients were control group. Results: Serum levels of RBP, albumin, transferrin and hemoglobin in the experimental group were significantly lower than those in the control group (P <0.001). After 7 days of nutritional support, serum RBP level was significantly higher than that at admission (P <0.001) Transferrin and hemoglobin were significantly higher than those at admission (P <0.05), while albumin levels were lower than those at admission (P> 0.05). Serum RBP levels were negatively correlated with APACHE II scores P <0.01). Conclusion: Serum RBP can timely and accurately reflect the effect of nutritional support in critically ill patients, and can dynamically assess the changes of the disease.