早产儿低蛋白血症.ppt

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,ReadingRF,EllisR,FleetwoodA.PlasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeksJ.EarlyHumanDevelopment,1990,22(2):81-87.MillerPW.Serumalbuminconcentrationsandoedemainthenewborn.J.ArchivesofDiseaseinChildhood,1986,61(7):657-60.,早产儿白蛋白水平,61pretermbabiesReadingRF,EllisR,FleetwoodA.PlasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeksJ.EarlyHumanDevelopment,1990,22(2):81-87.,早产儿白蛋白水平,61pretermbabiesReadingRF,EllisR,FleetwoodA.PlasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeksJ.EarlyHumanDevelopment,1990,22(2):81-87.,早产儿白蛋白水平,61pretermbabiesReadingRF,EllisR,FleetwoodA.PlasmaalbuminandtotalproteininpretermbabiesfrombirthtoeightweeksJ.EarlyHumanDevelopment,1990,22(2):81-87.,早产儿白蛋白水平,195infantsof25to42weeksMillerPW.Serumalbuminconcentrationsandoedemainthenewborn.J.ArchivesofDiseaseinChildhood,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,JardineLA,Jenkins-ManningS,DaviesMW.AlbumininfusionforlowserumalbumininpretermnewborninfantsJ.CochraneDatabaseofSystematicReviews,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,haveaplasmaalbuminlevelbelow30g/Lat48to72hoursoflife。Studysubjectswerenewborninfantswhowereventilatordependantatlessthansevendaysofageandhadaserumalbuminlevelof30g/Llowbirthweightnewborninfantsatriskforrespiratorydistresswhowereacidaemicwithalowtotalserumproteinlevel(whethertheywerehypoalbuminaemicornotisunknown).,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,SilviaI,FrancescoB,CatherineQ,etal.Totalplasmaproteininverypretermbabies:prognosticvalueandcomparisonwithillnessseverityscores.J.PlosOne,2013,8(4):e62210.761infantswerestudied(totalproteinleveloflessthan40g/L),plasmaproteinmeasurementsondayoneoflifeinverypreterminfantssevereadverseoutcome：Thiswasdefinedasdeathorsevere(grade3or4)intraventricularhemorrhageorcysticperiventricularleukomalaciaoccurringbeforeinfantsdischargefromhospital,Conclusions:Earlyhypoproteinemiahasprognosticvalueforsevereadverseoutcomeinverypreterm,sickinfants.TotalplasmaproteinhasapredictiveperformancecomparablewithCRIBandSNAPPE-IIandgreaterthanothervalidatedseverityscores.,1,2,早产儿早期，