颈脊髓损伤患者营养状况变化及其与死亡率的关系

Nutritional status changes of patients with cervical spinal cord injury and its relation with mortality

目的研究颈脊髓损伤患者营养状况的动态变化，分析其对患者死亡率的影响。方法将128例颈脊髓损伤依治疗结果分为非死亡组和死亡组。记录两组一般信息和血清总蛋白、血清白蛋白和血清前白蛋白水平。比较两组血清蛋白水平动态变化，分析其与死亡的关系。结果人院早期，血清总蛋白水平在死亡组降低；3—5d后，3种蛋白水平在死亡组均低于非死亡组（P〈0．05），死亡组下降幅度较大；患者较低的血清蛋白水平是死亡的危险因素。结论颈脊髓损伤患者伤后低蛋白血症在死亡患者中更为明显；低蛋白血症是此类患者死亡的危险因素。

Objective To assess the nutrition status changes in patients after cervical spinal cord injury, and determine which influences on the mortality. Methods All of 128 patients with cervical spinal cord injury were divided into two groups, death group and survivor group. For each patient, the general conditions and the serum biochemical parameters including serum total protein, serum albumin, serum prealbumin were measured after hospitalization. The dynamic changes of nutrition status were compared between the two groups, and a multivariate logistic regression analyses were done to identify the contribution of nutrition status on mortality. Results During the 14 days after hospitalization, the serum total protein level presented a decreased trend in the death group. After the 3~5 days of hospitalization, all the three serum protein level in death group were significantly lower than which in survivor group, an apparently reduce were found in the death group compared with survivor group. In the two groups, the averaged level of the three serum protein were both lower than the criterion standard of the hypoproteinemia and the malnutrition, and the death group were lower （P 〈0.05）. Multivariate logistic regression identified the lower serum total protein level, serum albumin and serum prealbumin level were independent predictors for the mortality. Conclusion Hypoproteinemia commonly exists in the patients with cervical spinal cord injury, which is more significantly in those died patients and represents an independent predictors of mortality.