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.     

Effectiveness of prealbumin as an indicator of growth in neonates

We designed this study to assess the effectiveness of prealbumin as an indicator of growth as well as a nutritional marker in neonates.Between March 2017 and June 2019, we measured serum prealbumin concentrations of 80 neonates in neonatal intensive care unit at birth, postnatal day 14 and 28, and classified them into 3 groups (early preterm, late preterm, and term infants). And we examined correlation among prealbumin levels, nutritional intake, and anthropometric measurements (weight, length, and head circumference) in neonates.Prealbumin measured on the 14th postnatal day in early preterm infants showed significant correlations with the length, weight, and head circumference z-scores. Prealbumin levels increased with time in the late preterm and term groups. At birth, prealbumin levels were the lowest in late preterm babies, implying that they are nutritionally deficient and need nutritional support. At postnatal day 28, the prealbumin levels of many preterm infants did not reach those seen in term babies at birth, suggesting the presence of extrauterine growth restriction.Prealbumin can be considered as an indicator of sufficient growth in early preterm infants.     

Serum prealbumin is a predictive biomarker for stroke-associated infection after an ischemic stroke

Background: Several prior studies have linked serum prealbumin (PA) as a predictor for perioperative infection. However, whether peripheral blood PA levels can be used as an indicator of stroke-associated infection (SAI) is still unclear. In this study, we attempt to find whether serum PA is a meaningful predictor in SAI after an ischemic stroke, so as to provide theoretical basis for clinical treatment. Methods: Consecutive patients with acute ischemic stroke who were admitted to our hospital were enrolled and serum PA was collected. A prospective study was conducted to observe the predictive value of PA in the SAI incident in ischemic stroke patients. Results: Of 104 patients, 29 (27.9%) developed an SAI after 7 d of follow-up. The stroke with SAI group had significantly lower PA levels than the stroke without SAI group ( p < 0.05). The optimal cutoff value for predicting SAI was PA ≤ 191 mg/L, with sensitivity and specificity of 58.62% and 81.33%, respectively. Kaplan–Meier survival analysis showed that stroke patients with low serum PA level (PA ≤ 191 mg/L) had a higher SAI rates (log-rank test, χ² = 16.870, p < 0.001). Cox regression analysis showed that PA ≤ 191 mg/L (hazard ratio = 3.207; 95% CI, 1.430–7.190, p = 0.005) was an independent risk factor for SAI. Conclusions: Early detection of serum PA during the acute phase of ischemic stroke may help us to identify at-risk SAI patients, and hence rapidly guide the intervention to prevent SAI.     

深度水解蛋白奶粉对过敏性紫癜儿童营养状况的应用研究

目的 探讨深度水解蛋白奶粉对过敏性紫癜儿童营养状况的作用和效果,为患儿寻找营养均衡的饮食治疗方法。方法 选取2014年1月-2015年6月在西安交通大学第二附属医院儿科住院治疗的过敏性紫癜患儿60例,随机将患儿分为限制饮食组30例,进食传统限制饮食;深度水解组30例,进食深度水解蛋白奶粉。同期选取在本科治疗的上呼吸道感染患儿30例作为正常对照组,进食正常饮食。于饮食治疗满1、2、3个月时分别给三组患儿进行膳食调查分析及血液生化检验。分析对比三组患儿营养素摄入水平和机体营养状况。结果 饮食治疗3个月后,限制饮食组大部分营养素摄入的实际/推荐百分比仍然低于60%,深度水解组全部营养素摄入的实际/推荐百分比达90%~110%之间,明显高于限制饮食组(P<0.05),与正常对照组相比差异无统计学意义(P>0.05)。深度水解组患儿的血清甘油三脂、胆固醇、前白蛋白、总蛋白和白蛋白水平与限制饮食组相比均明显升高(P<0.05),与正常对照组相比差异无统计学意义(P>0.05)。结论 深度水解蛋白奶粉应用于儿童过敏性紫癜饮食治疗中,提高患儿营养素及蛋白质的摄入水平,改善机体营养状况,利于患儿的健康成长。     

重度烧伤病人早期肠内营养支持的研究

目的:研究重度烧伤病人早期应用肠内营养支持的疗效及安全性。方法:41例烧伤面积超过30%的病人随机分为肠内营养组(TEN,n=21)和肠外营养支持为主的常规治疗组(CONT,n=20)。给与相当氮量和能量,7d后观察两组内脏蛋白、肿瘤坏死因子-α和预后炎症营养指数(prognosticinflammatoryandnutritionalindex,PINI)等的变化及不良反应。结果:TEN组前白蛋白水平(mg/L)从99.9±25.1上升至115.8±31.0,CONT组从96.0±31.8显著下降至69.4±17.3(P<0.01)。TEN组C-反应蛋白与TNF-α水平显著低于CONT组,CONT组的PINI值比TEN组显著升高;两组不良反应发生情况相当。结论:早期肠内营养支持改善重度烧伤病人营养状况的疗效优于常规治疗,安全可行。     

Human chorionic prealbumin: Identification,physicochemical properties and its detection in blood serum in trophoblastic diseases

Department of Biochemistry and Problem Laboratory for Immunochemistry of Malignant and Embryonic Tissues, N. I. Pirogov Second Moscow Medical Institute, Ministry of Health of the RSFSR. (Presented by Academician of the Academy of Medical Sciences of the USSR T. T. Berezov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 106, No. 11, pp. 552–553, November, 1988.     

肝炎后肝硬化患者前白蛋白合成速率的测定及临床评价

研究肝炎后肝硬化患者的前白蛋白合成速率与肝功能损害的关系.用首次静脉推注加恒速静脉滴注15N-赖氨酸示踪技术测定前白蛋白的合成速率.通过对12名正常人和23名肝硬化患者的测定发现:肝炎后肝硬化患者的前白蛋白合成速率明显降低,并与肝损害程度显著相关.该方法测定血浆前白蛋白合成速率,用于探讨肝脏本身蛋白质代谢障碍,及从动态角度认识和评价肝功能,为肝炎后肝硬化的研究提供了一项新的测定方法.     

血清前白蛋白检测在儿童急性血吸虫感染时的临床价值

为研究血清前白蛋白在儿童急性血吸虫感染时的动态变化,采用酶联免疫吸附试验对正常儿童与治疗前后血吸虫感染儿童血清前白蛋白进行测定。发现正常组血清前白蛋白含量与感染组治疗前相比较有非常显著性差异(t=3.7797,P<0.001);与感染组治疗后相比较无显著性差异(t=1.0254,P>0.05)。表明血清前白蛋白测定对儿童急性血吸虫感染患儿的肝损害程度的估计具有重要的参考价值。     

“Sporadic” prealbumin-related amyloid polyneuropathy: report of two cases

Summary Two sporadic cases of amyloid polyneuropathy are reported. There was no family history or plasma cell dyscrasia. Both showed sensorimotor and autonomic polyneuropathy with onset in the seventh decade. Amyloid deposits in both cases reacted with anti-human prealbumin sera but not with antisera to human AA and anti-human immunoglobulin light-chain amyloids, including A and A. One patient had the abnormal serum prealbumin and abnormal DNA sequence found in type I familial amyloid polyneuropathy (FAP) (Japanese type). Investigations in sporadic amyloid polyneuropathy should include immunohistochemistry, using antisera to the different amyloid proteins, and the radioimmunoassay and recombinant DNA techniques for diagnosis of FAP.