血清清蛋白评估极低出生体质量儿病情及预后的回顾性研究

A retrospective study of serum albumin in assessing the condition and prognosis of very low birth weight

目的探讨血清清蛋白(ALB)对极低出生体质量儿(VLBW)病情严重程度及预后的预测价值。方法回顾性分析2015年10月至2016年9月于该院新生儿科住院治疗的VLBW,比较出生体质量、胎龄、ALB、新生儿危重病例评分(NCIS)及预后。结果共纳入病例96例,平均出生体质量(1.32±0.15)kg,整体存活率80.21%,血清ALB(27.39±3.80)g/L。血清ALB<28g/L的VLBW出现新生儿呼吸窘迫综合征、败血症、机械通气、危重病例的发生率均高于血清ALB≥28g/L组,而存活率更低,差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC)下面积表明ALB、NCIS对VLBW存活预后有预测价值(曲线下面积分别为0.848,0.917,均大于0.5),但ALB的预测价值小于NCIS。Logistic回归分析显示血清ALB是影响VLBW预后的危险因素。结论血清ALB对VLBW病情危重程度及预后有一定的预测价值,但亚于NCIS。

Objective To explore the assessment value of serum albumin（ALB） to the severity and prognosis of very low birth weight（VLBW）. Methods The quality of birth weight,gestational age,serum albumin,critically ill scores and prognosis were analyzed retrospectively from October 2015 to September 2016 in this hospital. Results The mean birth weight was（1.32±0.15） kg, the overall survival rate was 80.21% and the serum albumin was （27.39± 3.80）g/L in 96 cases of patients. The occurrence rate of neonatal respiratory distress syndrome, sepsis, mechanical ventilation and critical cases were higher in albumin〈 28 g/L group than that of albumin≥28 g/L group,and the survival rate was lower, the difference were statistically significant（P〈0.05）. The area under ROC curve（AUC）showed that ALB and neonatal critical illness score（NCIS） had a predictive value for the survival of VLBW（AUC=0. 848,0. 917,P〈0.5）,but the predicted value of ALB was less than NCIS. According to Logistic analysis, ALB was the risk factors for survival rate in VLBW. Conclusion Serum ALB has a certain predictive value for the severity and prognosis of VLBW,but subgroups of NCIS.