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目的通过监测低白蛋白患者输入外源性白蛋白后血浆白蛋白浓度的变化水平,探讨外源性白蛋白对危重程度(APACHⅡ评分)不同的患者血浆白蛋白水平的影响。方法回顾性分析医院输注外源性蛋白的病例(72例)与未输注外源性白蛋白的病例(59例)进行24h血浆白蛋白水平比较。对输注白蛋白的患者按APACHEⅡ评分和输注白蛋白量分为轻症10g组、轻症20g组、重症10g组和重症20g组。对未输注白蛋白患者根据APACHEⅡ评分分为轻症对照组和重症对照组。患者输注前和输注24h后血浆白蛋白含量及APACHⅡ评分。结果输入白蛋白24h后,轻症10g组与重症10g组的血浆白蛋白浓度均无明显升高,2组与相应对照组比较差异无统计学意义(P>0.05);输入白蛋白24h后,轻症20g组与重症20g组的血浆白蛋白浓度均升高,与相应对照组比较差异均有统计学意义(P<0.05)。输注20g白蛋白24h后,血浆白蛋白的增长值:轻症20g组为(3.36±0.92)g/h、重症20g组为(1.81±1.07)g/L,分别与各组的APACHEⅡ评分变化值相关性分析,与轻症20g组无相关性(r=0.035,P>0.05);与重症20g组亦无相关性(r=0.143,P>0.05)。结论对危重患者,给予10g外源性白蛋白对患者血浆白蛋白水平无影响,给予20g外源性白蛋白24h后白蛋白水平升高。给予外源性白蛋白后不改变危重患者的预后,白蛋白增长的程度与APACHEⅡ评分无关。
Objective To investigate the effect of exogenous albumin on plasma albumin levels in patients with different severity (APACHⅡ score) by monitoring the level of plasma albumin after exogenous albumin administration in patients with hypoalbuminuria. Methods Retrospective analysis of hospital cases of exogenous protein infusion (72 cases) and not infused exogenous albumin cases (59 cases) for 24h plasma albumin levels. According to the APACHEⅡscore and albumin infusion, patients with albumin infusion were divided into mild 10g group, mild 20g group, severe 10g group and severe 20g group. Patients without albumin infusion were divided into mild control group and severe control group according to APACHEⅡscore. The levels of plasma albumin and APACH Ⅱ scores before and 24 h after infusion in patients. Results After the albumin was administered for 24 hours, there was no significant difference in plasma albumin concentrations between the mild 10g group and the severe 10g group. There was no significant difference between the two groups and the corresponding control group (P> 0.05) Serum albumin concentrations in mild 20g and severe 20g groups were all significantly higher than those in control group (P <0.05). The values of plasma albumin after infusing 20g albumin for 24h were (3.36 ± 0.92) g / h in mild 20g group and (1.81 ± 1.07) g / L in severe 20g group, respectively, which were significantly different from those of APACHEⅡscore group Correlation analysis showed no correlation with mild 20g group (r = 0.035, P> 0.05) and no correlation with severe 20g group (r = 0.143, P> 0.05). Conclusions For critically ill patients, administration of 10g exogenous albumin has no effect on the plasma albumin level of patients, and the level of albumin increases after 20g exogenous albumin is given for 24 hours. After administration of exogenous albumin did not change the prognosis of critically ill patients, the extent of albumin growth has nothing to do with the APACHE II score.