重症患者营养状况的动态变化与预后的相关性研究

目的研究重症患者营养变化趋势与其预后的相关性。方法对50例重症患者,分别于入科当天、第4d和1周后监测其血清前白蛋白、血清白蛋白、血清胆碱酯酶等营养指标,3个月后据疾病转归分为存活组和死亡组。入科24h内进行APACHEⅡ评分,据分值分为I组（APACHEⅡ〈20分）、Ⅱ组（APACHEⅡ≥20分）。结果 50例患者中,存活43例,死亡7例,存活组在3个时点的血清前白蛋白和血清白蛋白水平均明显高于死亡组（P〈0.05）;存活组和死亡组血清前白蛋白、血清白蛋白、血清胆碱酯酶动态变化曲线均呈下降的趋势,但死亡组与存活组比较,死亡组各营养指标值下降幅度更大（P〈0.05）。存活组APACHEⅡ分值低于死亡组（P〈0.05）。结论危重病患的营养状态是影响患者预后一个重要因素,动态监测其各项营养指标,积极进行营养干预治疗可有望改善其预后。

Correlation dynamic changes in nutrition and prognosis in critically ill patients

Objective To study the correlation of nutrition and their prognosis in critically ill patients.Methods 50 severe cases were admitted ICU of affiliated Hospital of Ningxia Medical University,and the serum prealbumin,serum albumin,serum cholinesterase nutritional indices were respectively detected at first,forth day and first week that patient were admitted.Three months later,the patients were divided into the survival group and death group according to prognosis.The patients were evaluated by APACHEⅡ score when they admitted to ICU within 24 hours.According to scores then they were divided into groups Ⅰ（APACHEⅡ 〈20 points） and group Ⅱ（APACHEⅡ ≥ 20 points）.Results Three months later,there were 43 cases survival,other 7 cases died.Although dynamic curve of serum prealbumin,serum albumin,cholinesterase of the survival group and death group showed a downward trend,and the serum prealbumin,serum albumin of survival group was significantly higher than those of death group at three time points（P〈0.05）.The score of APACHEⅡ of survival group were significantly lower than that in death group（P〈0.05）.Conclusion Nutritional status is an important prognostic factor for critical patients,and the nutritional therapy is expected to improve prognosis of critically ill patients.