危重病患者血清瘦素表达及营养评价指标的作用

Serum leptin expression in the critically ill patients and value of nutrition assessment markers

目的 探讨危重患者急性期禁食、全胃肠外营养 (TPN)治疗后血清瘦素的表达 ,以及营养评价指标对营养支持的作用。方法 用放射免疫法测定危重病患者血清瘦素 ,同时检测相关营养评价指标。结果 危重病患者急性期瘦素变化不明显 ,TPN治疗后迅速上升 ,第 3天达高峰 ,治疗后 5d仍高于正常。两组血浆纤维蛋白原、白蛋白、总胆固醇、甘油三脂、血淋巴细胞计数差异均无显著性意义 ,P >0 0 5。结论 危重病患者急性期禁食血清瘦素无显著性改变 ,但对TPN治疗反应迅速 ,血清瘦素有可能用来作为危重病患者急性期营养评价指标。血浆纤维蛋白原、白蛋白、总胆固醇、甘油三脂、淋巴细胞计数对危重病患者急性期营养状况无评价性作用。

Objective To explore serum leptin expression during fasting and after total parenteral nutrition(TPN) treatment in critycally ill patients,and to evaluate nutrition markers.Methods Serum leptin was tested by radioimmunoassay in the critically ill patients.Plasma fibrinogen,albumin,choleserol,glycerin,and blood lymphocytes were assayed.Results Serum leptin didn't change significantly during fasting,but rapidly increased after TPN treatment.Serum leptin peaked at third day.5 day after TPN treatment,serum leptin level was higher than that before treament.Plasma firbrinogen,albumin,cholesterol,glycerin,and blood lymphocytes didn't change significantly,P>0.05. Conclusion Serum leptin doesn't change significantly in critically ill patients during fasting,but serum rapidly increses after TPN treament.This shows that leptin can be as a marker to assess nutrition condition during nutrition support.Plasma fibrinogen,albumin,cholesterol,glycerin,and blood lymphocytes can't be used for assessing nutrition condition in acute critically ill patients.