乳清蛋白对急诊脓毒症合并低蛋白血症患者血清白蛋白及相关炎症因子的影响

Effects of Whey Protein on Serum Albumin and Correlated Inflammatory Cytokines of Aepsis Patients with Hypoalbuminemia

关键词:  乳清蛋白  肠内营养  脓毒血症  低蛋白血症  炎症指标

Key words:  whey protein  enteral nutrition  sepsis  hypoalbuminemia  inflammatory marker

摘要:

目的 观察乳清蛋白肠内营养对急诊脓毒症合并低蛋白血症的临床疗效及对患者血清中蛋白质和炎症指标水平的影响。方法 92例急诊脓毒症合并低蛋白血症患者随机分为对照组和观察组，每组46例。对照组患者给予常规基础治疗，观察组患者在此基础上给予乳清蛋白肠内营养治疗，比较2组患者治疗第28天的临床疗效、血清蛋白质水平、炎症指标及不良反应。结果 观察组患者治疗总有效率为82.61%，显著高于对照组的63.04%（P<0.05）。观察组患者白蛋白、前白蛋白、总蛋白治疗后显著高于对照组（P<0.05）；观察组患者炎症指标D-二聚体、C反应蛋白水平、降钙素原表达水平显著低于对照组（P<0.05）；治疗过程中未发生明显不良反应。结论 乳清蛋白对急诊脓毒症合并低蛋白血症患者临床效果显著，能够显著抑制炎症反应，建议临床推广使用。

Abstract:

OBJECTIVE To evaluate the clinical efficacy of whey protein on patients suffering from sepsis combined with hypoalbuminemia in emergency department and its influence on protein and inflammatory cytokines in serum. METHODS Ninty-two patients with sepsis and hypoalbuminemia were randomly divided into control group and observation group, 46 cases in each group. Control group was treated with basic treatment. Patients in observation group were treated with whey protein by enteral nutrition additionally. The clinical efficacy, the levels of protein and inflammatory cytokines in serum and adverse reactions were compared between the two groups. RESULTS The effective rate in observation group was 82.61%, significantly higher than 63.04% in control group (P<0.05). After treatment, the levels of albumin(ALB), prealbumin(PA) and total protein(TP) in observation group were significantly higher than those in control group (P<0.05). Inflammatory markers of D-dimer(D-D), C-reactive protein(CRP) and proealcitonin(PCT) in patients of the observation group were gradually decreased compared with the control group (P<0.05). During treatment, it showed no significant adverse reactions. CONCLUSION Whey protein has obvious curative effect and inhibit inflammatory response on sepsis combined with hypoalbuminemia, and it is suggested to apply in clinic.