中南大学学报（医学版）
中南大學學報（醫學版）
중남대학학보（의학판）
JOURNAL OF CENTRAL SOUTH UNIVERSITY (MEDICAL SCIENCES)
2014年
4期
401-407
,共7页
重症患者%胶体渗透压%白蛋白%球蛋白%纤维蛋白原
重癥患者%膠體滲透壓%白蛋白%毬蛋白%纖維蛋白原
중증환자%효체삼투압%백단백%구단백%섬유단백원
critically ill patients%COP%Alb%Glb%FIB
目的：分析重症患者全血胶体渗透压(colloid osmotic pressure，COP)的影响因素，制定血浆蛋白(plasma protein，PP)的参考值范围，改良COP的预测公式指导临床实践。方法：收集405例重症患者的一般资料和血气分析参数，按COP将患者分为A组(COP≤18mmHg)和B组(COP>18mmHg)，并监测总蛋白(total protein，TP)、白蛋白(Albumin，Alb)、球蛋白(Globumin，Glb)和纤维蛋白原(fibrinogen，FIB)。结果：B组的APACHE II评分显著低于A组(P<0.05)；B组TP，Alb，Glb和FIB水平以及存活率均高于A组(P<0.05)；Alb，Glb和FIB的标准化回归系数依次为0.518，0.283和0.113(P<0.05)；B组各类蛋白的95%参考值范围：Alb>23.3 g/L，Glb 12.6~37.6 g/L和FIB 1.3~8.7 g/L，改良得到预测COP的5个公式。结论：重症患者COP的主要影响因素依次为Alb，Glb和FIB。各类蛋白的参考值范围可指导蛋白制剂的临床使用，改良公式可以初步预测重症患者的COP。
目的：分析重癥患者全血膠體滲透壓(colloid osmotic pressure，COP)的影響因素，製定血漿蛋白(plasma protein，PP)的參攷值範圍，改良COP的預測公式指導臨床實踐。方法：收集405例重癥患者的一般資料和血氣分析參數，按COP將患者分為A組(COP≤18mmHg)和B組(COP>18mmHg)，併鑑測總蛋白(total protein，TP)、白蛋白(Albumin，Alb)、毬蛋白(Globumin，Glb)和纖維蛋白原(fibrinogen，FIB)。結果：B組的APACHE II評分顯著低于A組(P<0.05)；B組TP，Alb，Glb和FIB水平以及存活率均高于A組(P<0.05)；Alb，Glb和FIB的標準化迴歸繫數依次為0.518，0.283和0.113(P<0.05)；B組各類蛋白的95%參攷值範圍：Alb>23.3 g/L，Glb 12.6~37.6 g/L和FIB 1.3~8.7 g/L，改良得到預測COP的5箇公式。結論：重癥患者COP的主要影響因素依次為Alb，Glb和FIB。各類蛋白的參攷值範圍可指導蛋白製劑的臨床使用，改良公式可以初步預測重癥患者的COP。
목적：분석중증환자전혈효체삼투압(colloid osmotic pressure，COP)적영향인소，제정혈장단백(plasma protein，PP)적삼고치범위，개량COP적예측공식지도림상실천。방법：수집405례중증환자적일반자료화혈기분석삼수，안COP장환자분위A조(COP≤18mmHg)화B조(COP>18mmHg)，병감측총단백(total protein，TP)、백단백(Albumin，Alb)、구단백(Globumin，Glb)화섬유단백원(fibrinogen，FIB)。결과：B조적APACHE II평분현저저우A조(P<0.05)；B조TP，Alb，Glb화FIB수평이급존활솔균고우A조(P<0.05)；Alb，Glb화FIB적표준화회귀계수의차위0.518，0.283화0.113(P<0.05)；B조각류단백적95%삼고치범위：Alb>23.3 g/L，Glb 12.6~37.6 g/L화FIB 1.3~8.7 g/L，개량득도예측COP적5개공식。결론：중증환자COP적주요영향인소의차위Alb，Glb화FIB。각류단백적삼고치범위가지도단백제제적림상사용，개량공식가이초보예측중증환자적COP。
Objective: To analyze the influencing factors of whole blood colloid osmotic pressure (COP) and predict reference range of plasma protein for safe COP to guide clinical infusion of protein in critically ill patients. Methods: Physical data and blood gas analysis of 405 patients were collected. hTe patients were divided into 2 groups by COP: group A (COP≤18 mmHg) and group B (COP>18 mmHg). The serum proteins including total protein (TP), albumin (Alb), globumin (Glb) and ifbrinogen (FIB) were detected. Results: APACHE II of group B was signiifcantly lower than that of group A (P<0.05). hTe survival rate, TP, Alb, Glb and FIB of group B were significantly higher than these of group A (P<0.05).Standardized regression coeffcient of Alb, Glb and FIB was 0.518,0.283 and 0.113 (P<0.05); the 95% reference range of 4 types of protein level in group B: Alb>23.3 g/L,Glb 12.6-37.6 g/L and FIB 1.3-8.7 g/L; 5 reformed equations were made. Conclusion: The main influencing factors of COP include Alb, Glb and FIB. We can use the reference range of 4 types of protein level to guide the clinical management of protein agents, and reformed equations can be used to preliminarily forecast COP in critically ill patients.
