早产儿低蛋白血症.ppt

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1、早产儿低蛋白血症,颜卫源 2016-03-16,1,2,为早产儿输注白蛋白能否获益,3,扩展：生后第1天总蛋白水平与早产儿结局相关,目录,早产儿白蛋白水平,早产儿白蛋白水平,Reading R F,Ellis R,Fleetwood A.Plasma albumin and total protein in preterm babies from birth to eight weeksJ.Early Human Development,1990,22(2):81-87.Miller P W.Serum albumin concentrations and oedema in the newb

2、orn.J.Archives of Disease in Childhood,1986,61(7):657-60.,早产儿白蛋白水平,61 preterm babiesReading R F,Ellis R,Fleetwood A.Plasma albumin and total protein in preterm babies from birth to eight weeksJ.Early Human Development,1990,22(2):81-87.,早产儿白蛋白水平,61 preterm babiesReading R F,Ellis R,Fleetwood A.Plasma

3、 albumin and total protein in preterm babies from birth to eight weeksJ.Early Human Development,1990,22(2):81-87.,早产儿白蛋白水平,61 preterm babiesReading R F,Ellis R,Fleetwood A.Plasma albumin and total protein in preterm babies from birth to eight weeksJ.Early Human Development,1990,22(2):81-87.,早产儿白蛋白水平

4、,195 infants of 25 to 42 weeksMiller P W.Serum albumin concentrations and oedema in the newborn.J.Archives of Disease in Childhood,1986,61(7):657-60.,早产儿白蛋白水平,为早产儿输注白蛋白能否获益,Jardine LA,Jenkins-Manning S,Davies MW.Albumin infusion for low serum albumin in preterm newborn infantsJ.Cochrane Database of

5、Systematic Reviews,2004,3(3).,为早产儿输注白蛋白能否获益,结论尚缺乏有力的证据去证明为存在低蛋白血症的早产儿输注白蛋白能够改善死亡率，但同样没有足够的证据指出白蛋白有显著的副作用。,入选文献的白蛋白水平,have a plasma albumin level below 30 g/L at 48 to 72 hours of life。Study subjects were newborn infants who were ventilator dependant at less than seven days of age and had a serum alb

6、umin level of 30 g/L low birth weight newborn infants at risk for respiratory distress who were acidaemic with a low total serum protein level(whether they were hypoalbuminaemic or not is unknown).,仅有3篇文献入选,为早产儿输注白蛋白能否获益,早产儿早期，小于30g/L即输注白蛋白不一定能获益,总蛋白水平与早产儿严重不良结局相关,Silvia I,Francesco B,Catherine Q,et

7、 al.Total plasma protein in very preterm babies:prognostic value and comparison with illness severity scores.J.Plos One,2013,8(4):e62210.761 infants were studied(total protein level of less than 40 g/L),plasma protein measurements on day one of life in very preterm infantssevere adverse outcome：This

8、 was defined as death or severe(grade 3 or 4)intraventricular hemorrhage or cystic periventricular leukomalacia occurring before infants discharge from hospital,Conclusions:Early hypoproteinemia has prognostic value for severe adverse outcome in very preterm,sick infants.Total plasma protein has a predictive performance comparable with CRIB and SNAPPE-II and greater than other validated severity scores.,1,2,早产儿早期，小于30g/L即输注白蛋白不一定能获益,3,早产儿早期出现总蛋白水平降低预示出现严重不良结局的可能性大,总结,早产儿白蛋白水平应当大于20g/L,35周左右达到25g/L,39周左右达到30g/L.,谢谢,颜卫源 2016-03-16,