新生儿血清Alb与脓毒血症病情和预后的相关性

Correlation between serum Alb level and sepsis and prognosis in neonates

目的分析新生儿血清白蛋白(Alb)水平与早期脓毒血症病情诊断和预后的相关性分析。方法对浙江省余姚市人民医院2016年11月至2017年12月的122例新生儿的临床资料进行回顾性分析,分为脓毒血症组41例,非脓毒血症组54例,对照组27例。比较三组新生儿临床基本资料(性别、胎龄、日龄及出生体质量)、低蛋白血症和死亡的发生情况。依据新生儿Alb水平,分为A组(Alb低于25g/L)61例,B组(Alb为25~30g/L)29例,C组(Alb高于30g/L)32例。比较三组新生儿脓毒血症、多脏器功能障碍、住院时间及死亡的情况。结果脓毒血症组低蛋白血症(85.37%)和死亡率(14.63%)较非脓毒血症组(48.15%、1.85%)、对照组(22.22%、0)均显著升高(χ~2=28.01,P<0.05;χ~2=9.15,P<0.05)。A组脓毒血症(49.18%)、多脏器功能障碍(57.38%)及死亡率(1.48%)较B组(20.69%、13.79%、0)、C组(15.63%、9.38%、0)显著升高,且住院时间(12.87±1.46)d较B组(10.02±2.32)d、C组(8.96±2.11)d明显延长(χ~2=13.44,P<0.05;χ~2=28.60,P<0.05;χ~2=7.43,P<0.05;F=14.97,P<0.01)。结论新生儿血清Alb浓度越低,发生脓毒血症、多脏器功能障碍及死亡的风险性越高,住院时间明显延长,预后状况较差,提示血清Alb浓度可用于评估新生儿早期脓毒血症病情及预后状况。

Objective To analyze the correlation between serum albumin(Alb) level and early sepsis diagnosis and prognosis. Methods The clinical data of 122 neonates were analyzed retrospectively. They were divided into sepsis group(41 cases), non-sepsis group(54 cases) and control group(27 cases). The basic clinical data(gender, gestational age, day age and birth weight), hypoproteinemia and mortality were compared among three groups. According to the level of neonatal Alb, 61 cases were divided into group A(Alb<25 g/L), 29 cases in group B(Alb level ranged 25-30 g/L), 32 cases in group C(Alb>30 g/L). The neonatal sepsis, multiple organ dysfunction, hospitalization time and mortality were compared among three groups. Results Hypoproteinemia(85.37%) and mortality(14.63%) in sepsis group were significantly higher than those in non-sepsis group(48.15%, 1.85%) and control group(22.22%, 0%)(χ~2=28.01,P<0.05;χ~2=9.15,P<0.05). The sepsis(49.18%), multiple organ dysfunction(57.38%) and mortality(1.48%) in group A were significantly higher than those in group B(20.69%, 13.79%, 0%) and group C(15.63%, 9.38%, 0%). The hospitalization time [(12.87±1.46)d] was significantly longer than that in group B(10.02±2.32 d) and group C(8.96±2.11 d)(χ~2=13.44, P<0.05;χ~2=28.60, P<0.05;χ~2=7.43, P<0.05;F=14.97, P<0.01). Conclusion The lower the concentration of serum Alb, the higher the risk of sepsis, multiple organ dysfunction and death, and the longer the hospitalization time, the worse the prognosis, suggesting that the concentration of serum Alb can be used to evaluate the condition and prognosis of early neonatal sepsis.