全身炎症反应综合征患者低蛋白血症在急性呼吸窘迫综合征中的意义

Effects of Hypoproteinemla on Acate Respiratory Distress Syndrome in patients with SIRS

目的:分析血浆蛋白水平的不同与危重症患者ARDS的发生、病死率的关系。方法:测定符合SIRS标准245例患者血清蛋白水平,按血清蛋白水平分为低蛋白组(50g/L)、临界组(50～60g/L)、正常组(>60g/L),观察各组体重变化、ARDS发生率、病死率。结果:低蛋白组(50g/L)、临界组(50～60g/L)、正常组(>60g/L)患者ARDS发生率分别为45%、41%、21%,P=0.01;病死率分别为45%、47%、14%,P=0.03;体重变化分别为+4.5kg、+3.6kg、-2.8kg,P=0.004,结论:低蛋白血症是ARDS发生、死亡、液体潴留、体重增加的重要危险因素。

Purpose: Analysis to compare outcomes in patients and low serum total protein levels and outcomes in patients with normal surum total protein levels with respect to weight change,development of ARDS,and mortality. Methods:Initial serum total protein of 245 pa-tients who fulfilled the standard of SIRS were measured. These patients were redivided into three group according to the serum total protein, low borderline and normal. Weight change, ARDS development and mortality were observed. Results: We found that weight gain, ARDS devel-opment,and mortality were significantly different between the patients who had low or borderline serum total protein levels( <6g/dl) and the patients who had normal serum total protein. The incedance of ARDS were 45% ,41% and21%( P =0.01). The mortality were 45% ,47% and 14% ( P =0. 03). The weight change were +4. 5kg, +3. 6kg, -2. 8kg(P=0. 004). Conclusion: Hypoproteimia is significantly correlated with weight gain,ARDS development,and mortality in patients with SIRS.