早產兒低蛋白血癥ppt課件

早產兒低蛋白血癥 顏衛(wèi)源2016 03 16 1 2 為早產兒輸注白蛋白能否獲益 3 擴展 生后第1天總蛋白水平與早產兒結局相關 目錄 早產兒白蛋白水平 早產兒白蛋白水平 ReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 MillerPW Serumalbuminconcentrationsandoedemainthenewborn J ArchivesofDiseaseinChildhood 1986 61 7 657 60 早產兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產兒白蛋白水平 61pretermbabiesReadingRF EllisR FleetwoodA Plasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeks J EarlyHumanDevelopment 1990 22 2 81 87 早產兒白蛋白水平 195infantsof25to42weeksMillerPW Serumalbuminconcentrationsandoedemainthenewborn J ArchivesofDiseaseinChildhood 1986 61 7 657 60 早產兒白蛋白水平 為早產兒輸注白蛋白能否獲益 JardineLA Jenkins ManningS DaviesMW Albumininfusionforlowserumalbumininpretermnewborninfants J CochraneDatabaseofSystematicReviews 2004 3 3 為早產兒輸注白蛋白能否獲益 結論尚缺乏有力的證據去證明為存在低蛋白血癥的早產兒輸注白蛋白能夠改善死亡率 但同樣沒有足夠的證據指出白蛋白有顯著的副作用 入選文獻的白蛋白水平 haveaplasmaalbuminlevelbelow30g Lat48to72hoursoflife Studysubjectswerenewborninfantswhowereventilatordependantatlessthansevendaysofageandhadaserumalbuminlevelof 30g Llowbirthweightnewborninfantsatriskforrespiratorydistresswhowereacidaemicwithalowtotalserumproteinlevel whethertheywerehypoalbuminaemicornotisunknown 僅有3篇文獻入選 為早產兒輸注白蛋白能否獲益 早產兒早期 小于30g L即輸注白蛋白不一定能獲益 總蛋白水平與早產兒嚴重不良結局相關 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 早產兒早期 小于30g L即輸注白蛋白不一定能獲益 3 早產兒早期出現(xiàn)總蛋白水平降低預示出