血清前白蛋白评价早产儿营养状况的探讨

【目的】通过对早产儿血中前白蛋白和白蛋白水平的测定,探讨其作为评价早产儿营养状况的价值。【方法】采用免疫比浊法和溴甲酚绿法检测53例早产儿和57例足月儿血中前白蛋白和白蛋白水平。【结果】早产儿组前白蛋白和白蛋白水平明显低于足月儿组(P<0.01),低胎龄组早产儿前白蛋白水平明显低于高胎龄组早产儿(P<0.01)。【结论】前白蛋白是较白蛋白更为敏感的评估早产儿蛋白质-能量营养不良的指标。     

血清前白蛋白的测定在营养评价中的应用

３０多年来，肠外营养（ＰＮ）及肠内营养支持（ＥＮ）从理论到实践得到迅速发展，已成为临床治疗疾病，特别是挽救危重病人生命的重要措施之一。与此同时，以蛋白质－热量营养不良（ＰＥＭ）为核心的各种营养不良问题仍严重地影响着广大病人的疾病进程，甚至威胁着他们的...     

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.     

新生儿血清前白蛋白和氨基酸作为蛋白质营养指标的探讨

测定新生儿脐血、外周静脉血血清前白蛋白（ＰＡ）和２０种游离氨基酸（ＦＡＡ）。结果表明，小于胎龄儿（ＳＧＡ）血ＰＡ和几种氨基酸水平较适于胎龄儿（ＡＧＡ）显著降低，其氨基酸比率出现类似蛋白一能量营养不良者的氨基酸图谱。适于胎龄新生儿外周静脉血ＰＡ含量和大多数ＦＡＡ含量较脐血低，部分非必需氨基酸（ＮＥＡＡ）高于脐血。脐血与外周静脉血ＰＡ与总必需氨基酸／总氨基酸（ＴＥＡＡ／ＴＡＡ）比率均存在直线相关。结果提示：脐血或外周静脉血血清ＰＡ和ＦＡＡ同时测定可能作为评估新生儿宫内或宫外蛋白质营养状况的敏感生化指标。     

血清前白蛋白对肝病的诊断价值

为探讨血清前白蛋白（ＰＡ）对肝病的诊断意义,尤其是对重型肝炎预后的影响,采用速率散射比浊法检测了 １８３例各类肝病的血清 ＰＡ值。急性肝炎（ＡＨ） １４．７ ± ３．１ｍｇ／ｄｌ、慢性肝炎（ＣＨ） １２．７±２．６ｍｇ／ｄｌ、重型肝炎（ＦＨ） ５．８±１．７ｍｇ／ｄｌ、肝硬化（ＬＣ） ８．６±２．２ｍｇ／ｄｌ、原发性肝癌（ＰＨＣ）９．２±３．０ｍｇ／ｄｌ,与对照组（ＮＳ）３１．０±４．０ｍｇ／ｄｌ相比有高度显著性差异（ｐ＜０．０１）。ＰＡ值越低病情越重,重肝组ＰＡ≤８．０ｍｇ／ｄｌ的病死率７８．３％,ＰＡ＞８．１ｍｇ／ｄｌ的病死率３５．７％,有高度显著性差异（ｐ＜ ０．０１）。动态观察血清 ＰＡ值对重肝的预后有预测意义病程进展中ＰＡ值明显上升者预后好。８６％的急性肝炎ＰＡ值下降,而白蛋白（ＡＬＢ）下降的病例仅１１％,提示急性肝炎时ＰＡ值比ＡＬＢ更灵敏地反映肝功能损害。     

早期输注不同剂量氨基酸对早产儿血清前白蛋白的影响

目的:评价早期输注不同剂量氨基酸对早产儿血清前白蛋白的影响。方法:将2010年4月～2011年3月收治接受静脉营养的早产儿90例(胎龄≤32周,体重≤2 000 g)随机分成3组各30例,大剂量组于生后24 h内给予2.0 g·kg-1.d-1的氨基酸,每日递增1.0 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1;中剂量组于生后24 h内给予1.0 g·kg-1.d-1的氨基酸,每日递增0.5 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1;小剂量组生后24 h内给予0.5 g·kg-1.d-1的氨基酸,每日递增0.5 g·kg-1.d-1,最大剂量为3.5 g·kg-1.d-1。结果:各组出生第1天血清前白蛋白含量比较差异无统计学意义(P>0.05),但第7天血清前白蛋白浓度大剂量组与中剂量、小剂量组比较差异有统计学意义(P<0.05),中剂量组与小剂量组比较差异无统计学意义(P>0.05);第14天各组血清前白蛋白浓度比较差异有统计学意义(P<0.05)。结论:早期应用大剂量氨基酸可以提高血清前白蛋白浓度,从而改善早产儿的营养状况,促进生长发育。     

血清前白蛋白检测的临床应用

血清中前白蛋白（Prealbumin,PA）系由肝细胞制造的快速转运蛋白之一,每日全身代谢分解率为33．1％～39．5％,其半衰期仅为1．9d。肝损害时PA制造减少,故能真实敏感的反映肝脏功能,现已日益引起许多学者的重视,现综述如下。     

高龄老人血清白蛋白和血清前白蛋白水平分析

目的 观察高龄老人血清白蛋白、血清前白蛋白水平与疾病的关系.方法 ≧90岁高龄老人59例,根据所患疾病分为带瘤组(16例)、感染组(26例)和慢性病组(17例)3组,检测血清白蛋白、前白蛋白水平.结果 带瘤组血清白蛋白水平仁(32.38±3.42)g/L]低于感染组[(35.42±4.51)g/L]和慢性病组[(36.85±4.11)g/L],带瘤组血清前白蛋白水平[(12.88±3.72)g/L]低于感染组[(22.12±4.78)g/L]和慢性病组[(22.79±3.67)g/L],差异均有统计学意义(P<0.01).结论 高龄老人分解代谢增强,合成代谢减弱,容易发生负氮平衡;肿瘤的长期慢性消耗、营养摄入不足导致血清白蛋白和血清前白蛋白水平降低.     

血清前白蛋白和白蛋白测定在原发性肾病综合征中的临床意义

血清前白蛋白（PA）和白蛋白（ALB）均在肝细胞内合成,但在原发性肾病综合征时,PA、AIJ3也发生改变,本文就我院收治的肾病综合征患者的PA、ALB检验结果与正常人群作一对照,现报告如下。1材料和方法回．1检测对象健康对照组7百名,年龄在D一刀岁;肾病综合征患者为我院近半年来收治的病人对例,年龄ZI－56岁。1．2方法PA用上海玉兰生物技术研究所生产的免疫比浊法试剂盒,Alll用澳甲酚绿法,全部在日本岛津Cb－xx－x一全自动生化分析仪上测定,统计方法用均数t检验和相关分析。2结果健康对照组和肾综患者的PA、AIJ3均值见表1…     

不同程度营养不良青少年的血清前白蛋白测定

应用火箭免疫电泳法（ＥＩＤ），对３３６例营养不良青少年的血清前白蛋白含量进行了测定，结果显示营养不良青少年的血清前白蛋白浓度为３１．９８ｍｇ／ｄｌ；中度营养不良组（２４．３９±８．５４ｍｇ／ｄｌ）明显低于轻度营养不良组（３５．４８±６．７０ｍｇ／ｄｌ）。研究还发现营养不良青少年的血清前白蛋白浓度存在着年龄和性别差异。     

A comparison of serum transferrin and serum prealbumin as nutritional parameters

Serum transferrin and prealbumin levels were determined at intervals of 3 to 4 days in 16 patients requiring nutritional support. Caloric and nitrogen intake were measured and nitrogen balance calculated. There were 117 intervals available for analysis. A mean decrease in transferrin of 12.95 mg/dl was associated with a mean decrease in nitrogen balance of 0.92 g/day, whereas a mean increase in transferrin of 21.04 mg/dl was associated with a mean increase in nitrogen balance of 1.49 g/day; the correlation between changes in transferrin with changes in nitrogen balance was statistically significant (p = 0.02). Upward and downward changes in prealbumin were also associated with corresponding changes in nitrogen balance, but the changes were not statistically significant. Decreases in transferrin and prealbumin were also associated with a lower caloric intake. Operation caused a significant decrease in prealbumin (p = 0.003) and nitrogen balance (p = 0.05); a decrease in transferrin also occurred, but was not statistically significant. There was a highly significant correlation between serum transferrin and prealbumin (p = 0.001) and also between the interval changes in transferrin and prealbumin (p less than 0.001). In conclusion, transferrin was found to correlate closely with prealbumin. Changes in transferrin were more significantly related to changes in nitrogen balance, and from the results of this study, measurement of serum transferrin can be recommended as a useful parameter in following the nutritional status of patients receiving nutritional support.     

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.     

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.     

Plasma thyroxine binding prealbumin as an index of mild protein-energy malnutrition in Nigerian children

Weight, height, midarm circumference (AC), midarm muscle circumference (AMC), triceps skinfold thickness (TSF), and plasma thyroxine binding (TBPA) were measured in 73 children free from any clinical evidence of disease and in 15 severe protein-energy malnourished (PEM) (marasmus, marasmic kwashiorkor, and kwashiorkor) Nigerian preschool children. The children were divided into various groups according to both Wellcome and Waterlow's classification. All measurements made on them were then compared between the various groups within each classification. It was found that plasma TBPA values were not only able to distinguish various grades of PEM but was the only parameter studied which can distinguish mild PEM from normals when weight, height, TSF, AC, and AMC were not sensitive enough to do so. TBPA was also found to be significantly related to body weight, deficit in weight for age, AC, and AMC. Both marasmic and kwashiorkor groups had significantly lower TBPA levels than undernourished group. The marasmic children also had significantly lower body weight but higher TBPA levels than kwashiorkor, while the TBPA values for marasmic kwashiorkor children were in between the two. Considerable overlapping of individual TBPA values were found between normals and undernourished in Wellcome classification but very little overlapping was found between normals and mild PEM in Waterlow's classification.     

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.     

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。