1、1,早產(chǎn)兒低蛋白血癥,顏衛(wèi)源 2016-03-16,2,1,2,為早產(chǎn)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(chǎn)兒結(jié)局相關(guān),目錄,早產(chǎn)兒白蛋白水平,3,早產(chǎn)兒白蛋白水平,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 oede

2、ma in the newborn.J. Archives of Disease in Childhood, 1986, 61(7):657-60.,4,早產(chǎn)兒白蛋白水平,61 preterm babies 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.,5,早產(chǎn)兒白蛋白水平,61 preterm babies Reading R

3、 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.,6,早產(chǎn)兒白蛋白水平,61 preterm babies Reading R F, Ellis R, Fleetwood A. Plasma albumin and total protein in preterm babies from birth to eight weeksJ. Early Hu

4、man Development, 1990, 22(2):81-87.,7,早產(chǎn)兒白蛋白水平,195 infants of 25 to 42 weeks Miller P W. Serum albumin concentrations and oedema in the newborn.J. Archives of Disease in Childhood, 1986, 61(7):657-60.,8,早產(chǎn)兒白蛋白水平,9,為早產(chǎn)兒輸注白蛋白能否獲益,Jardine LA, Jenkins-Manning S, Davies MW. Albumin infusion for low serum

5、 albumin in preterm newborn infantsJ. Cochrane Database of Systematic Reviews, 2004, 3(3).,10,為早產(chǎn)兒輸注白蛋白能否獲益,結(jié)論 尚缺乏有力的證據(jù)去證明為存在低蛋白血癥的早產(chǎn)兒輸注白蛋白能夠改善死亡率，但同樣沒有足夠的證據(jù)指出白蛋白有顯著的副作用。,11,入選文獻的白蛋白水平,have a plasma albumin level below 30 g/L at 48 to 72 hours of life。 Study subjects were newborn infants who were ve

6、ntilator dependant at less than seven days of age and had a serum albumin 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).,僅有3篇文獻入選,12,為早產(chǎn)兒輸注白蛋白能否獲益,早產(chǎn)兒早期，

7、小于30g/L即輸注白蛋白不一定能獲益,13,總蛋白水平與早產(chǎn)兒嚴(yán)重不良結(jié)局相關(guān),Silvia I, Francesco B, Catherine Q, et 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 prote

8、in measurements on day one of life in very preterm infants severe adverse outcome：This was defined as death or severe (grade 3 or 4) intraventricular hemorrhage or cystic periventricular leukomalacia occurring before infants discharge from hospital,14,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