早產(chǎn)兒低蛋白血癥ppt課件

早產(chǎn)兒低蛋白血癥 顏衛(wèi)源2016 03 16 1 2 為早產(chǎn)兒輸注白蛋白能否獲益 3 擴(kuò)展 生后第1天總蛋白水平與早產(chǎn)兒結(jié)局相關(guān) 目錄 早產(chǎn)兒白蛋白水平 早產(chǎn)兒白蛋白水平 ReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 MillerPW Serumalbuminconcentrationsandoedemainthenewborn J ArchivesofDiseaseinChildhood 1986 61 7 657 60 早產(chǎn)兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產(chǎn)兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產(chǎn)兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產(chǎn)兒白蛋白水平 195infantsof25to42weeksMillerPW Serumalbuminconcentrationsandoedemainthenewborn J ArchivesofDiseaseinChildhood 1986 61 7 657 60 早產(chǎn)兒白蛋白水平 為早產(chǎn)兒輸注白蛋白能否獲益 JardineLA Jenkins ManningS DaviesMW Albumininfusionforlowserumalbumininpretermnewborninfants J CochraneDatabaseofSystematicReviews 2004 3 3 為早產(chǎn)兒輸注白蛋白能否獲益 結(jié)論尚缺乏有力的證據(jù)去證明為存在低蛋白血癥的早產(chǎn)兒輸注白蛋白能夠改善死亡率 但同樣沒(méi)有足夠的證據(jù)指出白蛋白有顯著的副作用 入選文獻(xiàn)的白蛋白水平 haveaplasmaalbuminlevelbelow30g Lat48to72hoursoflife Studysubjectswerenewborninfantswhowereventilatordependantatlessthansevendaysofageandhadaserumalbuminlevelof 30g Llowbirthweightnewborninfantsatriskforrespiratorydistresswhowereacidaemicwithalowtotalserumproteinlevel whethertheywerehypoalbuminaemicornotisunknown 僅有3篇文獻(xiàn)入選 為早產(chǎn)兒輸注白蛋白能否獲益 早產(chǎn)兒早期 小于30g L即輸注白蛋白不一定能獲益 總蛋白水平與早產(chǎn)兒嚴(yán)重不良結(jié)局相關(guān) SilviaI FrancescoB CatherineQ etal Totalplasmaproteininverypretermbabies prognosticvalueandcomparisonwithillnessseverityscores J PlosOne 2013 8 4 e62210 761infantswerestudied totalproteinleveloflessthan40g L plasmaproteinmeasurementsondayoneoflifeinverypreterminfantssevereadverseoutcome Thiswasdefinedasdeathorsevere grade3or4 intraventricularhemorrhageorcysticperiventricularleukomalaciaoccurringbeforeinfants dischargefromhospital Conclusions Earlyhypoproteinemiahasprognosticvalueforsevereadverseoutcomeinverypreterm sickinfants TotalplasmaproteinhasapredictiveperformancecomparablewithCRIBandSNAPPE IIandgreaterthanothervalidatedseverityscores 1 2 早產(chǎn)兒早期 小于30g L即輸注白蛋白不一定能獲益 3 早產(chǎn)兒早期出現(xiàn)總蛋白水平降低預(yù)示出