血清前白蛋白评价胎儿营养状况的研究

目的 探讨血清前白蛋白对胎儿营养状况的评价.方法 分别检测足月与早产新生儿脐血血清前白蛋白及母亲血清前白蛋白水平,正常体重与低出生体重新生儿脐血血清前白蛋白与母亲血清前白蛋白水平,并对有关数据进行比较分析.结果 足月儿与早产儿母亲血清前白蛋白比较无显著性差异(t=0.75,P>0.05),足月儿与早产儿脐血血清前白蛋白比较有显著性差异,(t=4.55,P<0.01);正常体重儿与低出生体重儿母亲和新生儿脐血血清前白蛋白水平的比较均有显著性差异(t值分别为4.33、5.73,均P<0.05).结论 血清前白蛋白对孕妇及胎儿营养状况有评价作用.血清前白蛋白水平可成为反映围产因素造成胎儿宫内营养不良的敏感指标.     

Utilization of prealbumin as a nutritional parameter

The response of prealbumin was compared to that of albumin and transferrin in 16 patients following 7 days of metabolic/nutritional support. Baseline values were compared to day 7 results to assess the degree of change. Prealbumin demonstrated a significant increase in the mean serum concentration (13.0 vs 19.6 mg/100 ml) in the presence of a positive nitrogen balance. Transferrin exhibited a similar significant response (168.8 vs 223.7 mg/100 ml). Albumin, body weight, and serum iron concentration did not change significantly during the 7-day period. Prealbumin effectively demonstrated an anabolic response in the study sample and could possibly be used as an early indicator of visceral protein anabolism in patients receiving metabolic/nutritional support.     

The effect of iron-deficiency anaemia on two indices of nutritional status, prealbumin and transferrin

1. Serum prealbumin, transferrin and iron concentrations were measured in ninety-two north Cameroonian children under 5 years of age. The results were grouped according to the blood haemoglobin concentration range in order to show the interactions of anaemia with prealbumin and transferrin concentrations. 2. Transferrin concentration showed a significant negative correlation with serum Fe and percentage saturation of transferrin values. Prealbumin concentration showed a significant direct correlation with haemoglobin but did not correlate with either serum Fe or percentage saturation of transferrin. 3. It is concluded that in regions where Fe-deficiency anaemia is endemic transferrin concentration may be of little value in determining nutritional status. On the contrary, prealbumin seems to be more useful.     

纤维连接蛋白和前清蛋白在营养支持效果评价中的作用

目的:评价纤维连接蛋白和前清蛋白作为腹部外科术后营养支持效果指标的意义.方法:测定腹部外科术后病人行营养支持前后的血清清蛋白、转铁蛋白、前清蛋白和纤维连接蛋白水平,并测定营养支持期间每天氮平衡.结果:与营养支持前相比,血清转铁蛋白、前清蛋白和纤维连接蛋白水平在营养支持后明显升高(P＜0.05),前清蛋白与纤维连接蛋白水平的升高呈正相关.结论:血清纤维连接蛋白和前清蛋白对评价术后营养支持效果有一定的参考价值.     

Serum transferrin and serum prealbumin are early predictors of serum albumin in chronic hemodialysis patients.

Protein-calorie malnutrition is a known risk factor for increased morbidity and mortality in maintenance hemodialysis patients (MHD). Serum albumin is the most commonly measured nutritional index in MHD patients because of its easy routine availability and association with outcomes of interest. However, its long half-life of approximately 20 days makes it a late index of nutritional status, and its exclusive use may delay implementation of appropriate nutritional interventions. Serum prealbumin and transferrin have been proposed as earlier nutritional markers. However, the temporal associations among these indices and serum albumin have not been well documented. To assess the ability of serum prealbumin and serum transferrin to predict changes in serum albumin over time, we prospectively analyzed these parameters in 105 MHD patients every month for 6 consecutive months. The mixed model analysis showed that early changes in either serum transferrin or prealbumin predicted and were significantly associated with changes in serum albumin (P<.0001). Using a prototype equation, a change of 0.12 g/dL in serum albumin concentration can be predicted by a 10% change in the same direction of serum transferrin and prealbumin. We conclude that clinically significant changes in albumin can be reliably predicted by earlier changes in serum transferrin and prealbumin.     

酶联免疫吸附法测定健康成人的血清前白蛋白、转铁蛋白和视黄醇结合蛋白

目的:探讨酶联免疫吸附法测定前白蛋白(PA)、转铁蛋白(TRF)和视黄醇结合蛋白(RBP)的价值.方法:用酶联免疫吸附法测定32份健康成人血清样品的PA、TRF和RBP.结果:血清RBP为37.38±11.37 mg/L,PA为277.9±51.2 mg/L,TRF为2.61±0.36 g/L;并且RBP、PA和TRF之间有显著相关.结论:采用酶联免疫吸附法测定PA、TRF和RBP,简便、易行,且重复性好.     

The effect of severe zinc deficiency on serum levels of albumin, transferrin, and prealbumin in man

Concentrations of three serum transport proteins, albumin, transferrin, and prealbumin, were determined in seven patients with severe zinc deficiency. Zinc deficiency was manifested not only by depressed serum zinc concentrations, but also by skin lesions typical of zinc deficiency that corrected with zinc supplementation only. Concentrations of all three serum proteins were significantly depressed in zinc-deficient patients compared to healthy controls, and levels of all three proteins improved or corrected with a short period of zinc supplementation as the sole form of therapeutic intervention. Prealbumin levels dropped and corrected most rapidly, probably due in part to its short half-life of 2 days. This study demonstrates that zinc plays an important role in protein metabolism in man and is necessary for the maintenance of normal levels of certain transport proteins. These results support the possibility that zinc deficiency may alter tissue availability of other nutrients such as vitamin A or iron through its effect on transport proteins.     

肝病患者血清前白蛋白检测临床意义分析

目的：探讨对各种肝病患者检测血清前白蛋白（PA）的临床意义。方法对我院2011年6月-2013年10月收治的100例门诊和住院各种肝病患者进行PA及血清总蛋白（TP）进行测定,在组间进行对比的同时与同期50例健康者进行以上指标的比较。结果与健康者比较,所有肝病患者PA均有所下降（P〈0.05）,肝癌及肝硬化PA降低率最高。肝癌及肝硬化的TP与健康组比较有明显下降（P〈0.05）,急性和慢性肝炎患者TP与健康组无明显差异（P〉0.05）。结论 PA的水平是显示肝功能的重要及敏感指标,对诊断和预后有指导意义。     

视黄醇结合蛋白、前白蛋白对胎儿宫内营养状况评估价值研究

目的 探讨视黄醇结合蛋白(RBP)、前白蛋白(PA)评价胎儿宫内营养状况的临床价值.方法 选择2015年在淮北市妇幼保健院分娩的338例新生儿作为研究对象,按胎龄分为早产儿组137例和足月儿组201例,生后12h内取静脉血检测RBP、PA水平,比较不同分组新生儿RBP、PA水平并分析RBP、PA水平对胎儿宫内营养状况的评价效果.结果 足月儿组血清RBP和PA水平均显著高于早产儿组(t值分别为5.548、4.337,均P<0.05),35~36周早产儿组血清RBP、PA水平均显著高于28~34周早产儿组(t值分别为5.097、9.007,均P<0.05),低体重儿组新生儿血清RBP、PA水平均显著低于其他两组RBP:t值分别为5.379、5.882,均P<0.05;PA:t值分别为6.498、7.267,均P<0.05),而巨大儿组新生儿血清RBP、PA水平均显著高于其他两组(t值分别为4.276、5.034,均P<0.05).结论 血清RBP、PA综合评价能够准确快速判断胎儿宫内营养状况,在临床上具有重要应用价值.     

Improving nutritional screening of hospitalized patients: the role of prealbumin

BACKGROUND: Limited resources prevent hospitals from having all patients formally evaluated by a nutrition expert. Thus, hospitals rely on nutrition-screening tools to identify malnourished patients. The purpose of this study was to determine the effectiveness of a nutrition-screening protocol, prealbumin (PAB), retinol binding protein (RBP), and albumin (ALB) in identifying malnourished hospitalized patients. METHODS: A nutrition screening protocol was prospectively used in medical and surgical patients and consisted of a nurse administering a questionnaire to patients and requesting formal evaluation by a registered dietitian (RD) only if nutritional issues were identified. Patients also had ALB, PAB, and RBP drawn, which were used to both screen and identify the malnourished. PAB, RBP, and ALB were compared as predictors of RD classification of patient nutritional status. RESULTS: The nutrition-screening protocol classified 104 of 320 patients (33%) as malnourished. However, 43% of the patients were not deemed at nutritional risk according to this protocol and therefore did not receive RD assessment. PAB was a significant predictor of RD-determined nutritional status (p < .05), whereas RBP and ALB were not. PAB screening/assessment identified 50% (162/320) of the patients as being malnourished. Notably, 50% of the patients (71 of 142) who were not evaluated by an RD were identified as malnourished using PAB criteria. The nutrition-screening protocol took 1.2 days longer to determine malnourishment compared with PAB (p = .0021). CONCLUSIONS: Use of screening questionnaires may miss or delay identification of malnourished patients. PAB screening/assessment may improve identification of those patients requiring nutrition intervention and thus enhance the care of hospitalized individuals.     

Elevated serum transferrin saturation and mortality

BACKGROUND: A large proportion of US adults have elevated transferrin saturation, an indicator of a predisposition for iron overload. The purpose of this study was to evaluate the relationship between elevated serum transferrin saturation and mortality. METHODS: This cohort study was conducted using data from the First Health and Nutrition Examination Survey 1 (1971-1974) (NHANES I) merged with the NHANES I Epidemiologic Followup Study (1992) (N = 10,714). We used SUDAAN and appropriate weights to make population estimates for the adult US population (aged 25 to 74 years at baseline). All-cause mortality was evaluated in relation to serum transferrin saturation of greater than 45%, greater than 50%, greater than 55%, and greater than 60% using Cox proportional hazards regression. RESULTS: In a Cox proportional hazards model controlling for potential confounders, including comorbid diseases, smoking, and cholesterol, all-cause mortality is significantly greater for persons with a serum transferrin saturation of more than 55%, compared with those with saturations below this cutoff (hazards ratio [HR] = 1.60, 95% confidence interval [CI], 1.17-2.21). No one who died had hemochromatosis as any of the 20 listed causes of death. Many of the underlying causes of death for persons with serum transferrin saturation levels of more than 55% are common causes of death in the general population, although these persons were more likely to have died of cirrhosis and diabetes, a finding consistent with iron overload. CONCLUSIONS: In this nationally representative cohort of adults, those with elevated serum transferrin saturation, more than 2% of the adult US population, were at increased risk for all-cause mortality.     

Relationship of serum leptin levels and selected nutritional parameters in patients with protein-caloric malnutrition

Leptin is a protein hormone produced by adipocytes that reflects the body fat content, i.e., its serum concentration in healthy individuals positively correlates with the body mass index and body fat content. Serum leptin levels are lower in both patients with anorexia nervosa and protein-caloric malnutrition caused by chronic non-malignant illnesses. The aim of the present study was to compare serum leptin levels and selected, routinely used nutritional parameters in women with anorexia nervosa (n = 17), severely malnourished patients with short bowel syndrome (n = 13), and control non-obese healthy women (n = 17) to clarify the relation between selected nutritional parameters and serum leptin levels. We found that serum leptin levels in the anorexia nervosa and short bowel syndrome groups were significantly lower than those in the control group (in ng/mL: 3.63 +/- 1.64 and 2.59 +/- 1.17 versus 12.06 +/- 7.59, respectively). Protein malnutrition expressed by decrease in serum concentrations of total protein, albumin, and prealbumin was more pronounced in the short bowel syndrome group. Triceps skin fold, arm muscle circumference, and body mass index were significantly lower in the patient group than in the control group and did not significantly differ between the short bowel syndrome and anorexia nervosa groups. No significant difference in serum leptin concentration between the short bowel syndrome and anorexia nervosa groups was found. Serum leptin levels correlated positively with body mass index and triceps skin fold in the control and anorexia nervosa groups but not in the short bowel syndrome group. We conclude that serum leptin levels in patients with anorexia nervosa and short bowel syndrome are significantly lower than in healthy individuals and have no statistically significant relation to serum total protein, abumin, and prealbumin.     

血清铁、铁蛋白、转铁蛋白联合检测在儿童营养性缺铁性贫血筛查中的价值

目的探讨血清铁(SI)、铁蛋白(SF)、转铁蛋白(TRF)联合检测在儿童营养性缺铁性贫血筛查中的应用价值,为临床诊治提供参考。方法选取2016年3月-2017年6月在绵阳市中心医院接受诊治的80例营养性缺铁性贫血患儿作为研究组(A组),另选取同期在该院接受诊治的74例非营养性缺铁性贫血患儿作为非缺铁性贫血组(B组),选取同期在该院接受健康体检的70例正常儿童作为对照组(C组),3组儿童均接受SI、SF、TRF检测,对比单独检测与联合检测的敏感性、特异性及准确度。结果A组患儿的血清SI、SF水平均低于B组、C组,B组患儿的血清SI、SF水平均高于C组,差异有统计学意义(P<0.05)。A组患儿的血清TRF高于B组、C组,B组患儿的血清TRF水平高于C组,差异有统计学意义(P<0.05)。联合检测敏感性、准确度均高于血清SI及SF、TRF单独检测,差异有统计学意义(P<0.05)。结论SI、SF、TRF联合检测在儿童营养性缺铁性贫血筛查中应用价值高,能有效反映机体储存、利用铁情况,利于鉴别、诊断营养性缺铁性贫血,提高诊断敏感性、准确性,值得临床推广。     

A comparison between carboxyhemoglobin and serum thiocyanate determinations as indicators of cigarette smoking.

Cigarette smoking histories were compared to carboxyhemoglobin and serum thiocyanate concentrations obtained from 426 smokers and 191 non-smokers. The mean levels of both carboxyhemoglobin and serum thiocyanate wefe significantly higher among cigarette smokers and correlated with number of cigarettes smoked per day. The specificity of both procedures was 81 per cent, and serum thiocyanate had a higher sensitivity (93 per cent vs. 83 per cent), making it potentially more suitable for use as an index of cigarette smoking.     

脓毒血症患儿血清胆碱酯酶与前白蛋白含量的预警价值

目的 通过观察胆碱酯酶(CHE)以及前白蛋白(PA)在血清中的含量变化,探讨其在脓毒血症病情进展中的预警价值,以期早期干预.方法 将脓毒症患儿依据病情转归分为治愈组23例、死亡组16例,全部于入院即刻及治疗3d检测血清胆碱酯酶、前白蛋白含量,并随机选取25名正常体检儿童作为对照组.结果 死亡组入组当天血清胆碱酯酶(3157.7±652.14)U/L、前白蛋白(104.76±43.23) mg/L较治愈组当天血清胆碱酯酶(3235.53±741.56)U/L、前白蛋白(162.87±74.34)mg/L明显降低,差异均有统计学意义(P＜0.01);第3天死亡组血清胆碱酯酶(2178.63±724.02)U/L、前白蛋白(84.65±26.58)mg/L进一步降低(P＜0.01),治愈组胆碱酯酶(3987.14±826.43)U/L、前白蛋白值(172.89±52.13)mg/L较入院时均有所上升;两组血清胆碱酯酶、前白蛋白均比对照组明显降低,差异均有统计学意义(P＜0.01).结论 血清胆碱酯酶、前白蛋白的动态变化,对判断脓毒血症患儿疗效及预后具有参考价值,有利于对病情进行早期干预.