Hypoalbuminemia in colorectal cancer prognosis:Nutritional marker or inflammatory surrogate?

Albumin is the single most abundant protein in the human serum. Its roles in physiology and pathology are diverse. Serum albumin levels have been classically thought to reflect the nutritional status of patients. This concept has been challenged in the last two decades as multiple factors, such as inflammation, appeared to affect albumin levels independent of nutrition. In general, cancer patients have a high prevalence of hypoalbuminemia. As such, the role of hypoalbuminemia in patients with colorectal cancer has received significant interest. We reviewed the English literature on the prognostic value of pretreatment albumin levels in colorectal cancer. We also consolidated the evidence that led to the current understanding of hypoalbuminemia as an inflammatory marker rather than as a nutritional one among patients with colorectal cancer.

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

AIM:To determine the relationship between pre-operative hypoalbuminemia and the development of complications following rectal cancer surgery, as well as postoperative bowel function and hospital stay. METHODS:The medical records of 244 patients undergoing elective oncological resection for rectal adenocarcinoma at Siriraj Hospital during 2003 and 2006 were reviewed. The patients had pre-operative serum albumin assessment. Albumin less than 35 g/L was recognized as hypoalbuminemia. Postoperative outcomes, including mortality, complications, time to first bowel movement, time to first defecation, time to resumption of normal diet and length of hospital stay, were analyzed. RESULTS:The patients were 139 males (57%) and 105 females (43%) with mean age of 62 years. Fifty-six patients (23%) had hypoalbuminemia. Hypoalbuminemic patients had a significantly larger tumor size and lower body mass index compared with non-hypoalbuminemic patients (5.5 vs 4.3 cm;P < 0.001 and 21.9 vs 23.2 kg/m2;P = 0.02, respectively). Thirty day postoperative mortality was 1.2%. Overall complication rate was 25%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (37.5% vs 21.3%;P = 0.014). In univariate analysis, hypoalbuminemia and ASA status were two risk factors for postoperative complications. In multivariate analysis, hypoalbuminemia was the only significant risk factor (odds ratio 2.22,95% CI 1.17-4.23;P < 0.015). Hospitalization in hypoalbuminemic patients was significantly longer than that in non-hypoalbuminemic patients (13 vs 10 d, P = 0.034), but the parameters of postoperative bowel function were not significantly different between the two groups. CONCLUSION:Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following rectal cancer surgery.

Multiple chronic non-specific ulcer of small intestine characterized by anemia and hypoalbuminemia

A female patient with anemia and hypoalbuminemia was admitted to our hospital due to an over 20-year history of recurrent dizziness,fatigue and ankle edema.She was diagnosed as multiple chronic nonspecific ulcer of the small intestine characterized by non-specific histology and persistent gastrointestinal bleeding.

Implications of preoperative hypoalbuminemia in colorectal surgery

Serum albumin has traditionally been used as a quantitative measure of a patient's nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient's chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.

Association of post.treatment hypoalbuminemia and survival in Chinese patients with metastatic renal cell carcinoma

Background:Hypoalbuminemia adversely affects the clinical outcomes of various cancers.The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3-5 weeks after treatment in patients with metastatic renal cell carcinoma(mRCC) who received sorafenib or sunitinib as first-line treatment.Methods:In this single-center,retrospective study,we assessed the progression-free survival(PFS) and overall survival(OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment.PFS and OS were compared between patients with post-treatment hypoalbuminemia(post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level(albumin level≥36.4 g/L).The Memorial Sloan Kettering Cancer Center(MSKCC)risk model stratified mRCC patients into three risk categories.Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models.Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis.Results:The median PFS and OS of the 184 patients were 11 months(95%confidence interval[CI]9-12 months)and 23 months(95%CI 19-33 months),respectively.Patients with post-treatment hypoalbuminemia had significantly shorter median PFS(6 months[95%CI 5-7 months]) and OS(11 months[95%CI 9-15 months]) than patients who had normal post-treatment albumin levels(PFS:12 months[95%CI 11-16 months],P < 0.001;OS:31 months[95%CI24-42 months],P < 0.001),respectively.Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS(hazard ratio[HR],2.113;95%CI 1.390-3.212;P < 0.001) and OS(HR,2.388;95%CI 1.591-3.585;P < 0.001).Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS.The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS(c-index:0.68 and 0.73,respectively) compared with the basic MSKCC risk model(c-index:0.67 and 0.70,respectively).The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis(both P < 0.001).Conclusions:Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors.Additionally,integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.

Causal relationship between hypoalbuminemia and acute kidney injury

Our meta-analysis published in 2010 provided evidence that low levels of serum albumin （hypoalbuminemia） are a signifcant independent predictor of acute kidney injury （AKI） and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk. Eligible studies published from September 2009 to December 2016 were sought in PubMed （MEDLINE） and forty-three were retained, the great majority being retrospective observational cohort studies. These included a total of about 68000 subjects across a diverse range of settings, predominantly cardiac surgery and acute coronary interventions, infectious diseases, transplant surgery, and cancer. Appraisal of this latest data set served to conclusively corroborate and confirm our earlier hypothesis that lower serum albumin is an independent predictor both of AKI and death after AKI, across a range of clinical scenarios. The body of evidence indicates that hypoalbuminemia may causally contribute to development of AKI. Furthermore, administration of human albumin solution has the po-tential to prevent AKI; a randomized, controlled study provides evidence that correcting hypoalbuminemia may be renal-protective. Therefore, measurement of serum albumin to diagnose hypoalbuminemia may help identify high-risk patients who may beneft from treatment with exogenous human albumin. Multi-center, prospective, randomized, interventional studies are warranted, along with basic research to define the mechanisms throughwhich albumin affords nephroprotection.

老年早期胃癌患者内镜治疗术后伴发营养不良的风险预测模型构建

目的 分析老年早期胃癌患者行内镜黏膜下剥离术(ESD)、内镜黏膜切除术(EMR)居家伴发营养不良的影响因素。方法 选取2022年1月-2023年12月在江苏省中医院接受早期胃癌行ESD或EMR治疗的80例老年患者作为研究对象,根据术后在居家环境中是否发生营养不良,将患者分为发生营养不良组(n=45)和未发生营养不良组(n=35)。采用单因素和多因素分析方法,探讨影响营养不良发生的高危因素。结果 单因素分析显示,2组高血压、血钾、血糖、血红蛋白检测值差异无统计学意义(P>0.05)。2组年龄、文化程度、焦虑得分、抑郁得分、早饱感、人格特质、术前低蛋白血症、术前血钙等均与胃癌患者术后发生营养不良有关(均P<0.05)。Logistic回归分析显示,年龄>75岁、抑郁得分>35分、有早饱感、焦虑得分≥29分、术前低蛋白血症等均为导致胃癌患者术后发生营养不良的独立危险因素(P<0.05)。以模型新生成概率值为依据,对该模型进行数据验证,绘制预测模型ROC曲线,可见AUC=0.862(95%CI:0.795~0.859)>0.75,最佳临界值为0.554,提示模型具有一定的预测能力。Hosmer-Lemeshow检验评价模型校准能力(χ^(2)=0.879,P=0.761>0.05),提示模型有良好的拟合优度。DCA结果显示,当营养不良临界概率值在9%~95%时,使用该模型能够获得较高的净收益。结论 本研究构建的老年早期胃癌患者术后营养不良风险预测模型,通过多因素Logistic回归分析发现,年龄>75岁、抑郁得分>35分、有早饱感、焦虑得分≥29分、术前低蛋白血症等可能为其独立危险因素。该模型经数据验证,具有较好的预测能力和校准度,且在营养不良临界概率值范围内显示出较高的净收益,可为临床实践中老年早期胃癌患者的术后营养管理提供参考。

食管癌术后吻合口瘘的危险因素研究

目的探讨食管癌患者术后发生吻合口瘘的危险因素。方法回顾性分析107例食管癌手术患者的临床资料,将术后发生吻合口瘘的21例患者纳入观察组,将术后未发生吻合口瘘的86例患者纳入对照组,通过单因素分析和多因素Logistic回归分析明确食管癌术后发生吻合口瘘的危险因素。结果单因素分析结果显示,年龄、低蛋白血症、糖尿病史、术前新辅助治疗、吻合部位均与食管癌术后吻合口瘘有关(P<0.05);多因素Logistic回归分析显示,术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素(OR=5.392,95%CI:1.335~30.382,P=0.020)。结论术前接受新辅助治疗是食管癌患者术后发生吻合口瘘的独立危险因素,对于术前合并其他系统疾病尤其是糖尿病、低蛋白血症的高危患者,应做好充分的术前准备。

人体感染狒狒巴拉姆希阿米巴脑炎1例报告

目的探讨狒狒巴拉姆希阿米巴脑炎的临床特点、诊断方法和治疗策略。方法回顾性分析病例资料。结果患者入院时检查异常的指标有:呼吸道病原体IgM阳性,华大基因测序结果检出狒狒巴拉姆希阿米巴的检出序列数为55,脑脊液分析结果显示白细胞计数为371×10^(6)/L,蛋白定量为3321.4 mg/L,葡萄糖为2.33 mmol/L,氯化物为110 mmol/L,这些数据表明,患者存在严重感染症和免疫紊乱。经过6 d治疗,患者的病情虽有所好转,仍然危重。由于缺乏特效药物,预后极差,家属要求出院。结论狒狒巴拉姆希阿米巴脑炎是一种罕见但危险的疾病,临床表现多样,诊断难度较大,缺乏特效药物,治疗难度极大,预后极差。但对于疑似狒狒巴拉姆希阿米巴脑炎的患者,乃应早期进行综合性治疗,包括抗感染、免疫调节等治疗措施。

持续非卧床腹膜透析患者低蛋白血症的影响因素分析

目的:分析持续非卧床腹膜透析(CAPD)患者低蛋白血症的影响因素。方法:回顾性分析2018年1月—2022年12月玉林市第一人民医院收治的CAPD患者,按血清白蛋白水平分为低蛋白组(n=132)和正常蛋白组(n=215),比较两组临床资料,使用Logistic回归分析模型分析低蛋白血症的危险因素。结果:低蛋白组的血清白蛋白、左室射血分数、白细胞、血红蛋白、球蛋白、前白蛋白、总胆固醇、甘油三酯和血钙水平低于正常蛋白组,24 h腹透液蛋白浓度、24 h腹透液蛋白总量高于正常蛋白组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,左室射血分数、血红蛋白、前白蛋白和甘油三酯下降是CAPD患者低蛋白血症的影响因素(P<0.05)。结论:CAPD患者低蛋白血症发生率较高。左室射血分数、血红蛋白、前白蛋白和甘油三酯下降是CAPD患者低蛋白血症的影响因素。积极预防和治疗心力衰竭与心肌重构,纠正贫血,进行营养评估和干预,以预防低蛋白血症的发生。

四肢创伤骨折病人术后低蛋白血症的危险因素分析及风险预测模型的构建

目的 探讨四肢创伤骨折病人术后低蛋白血症的危险因素,并构建四肢创伤骨折病人术后低蛋白血症的风险预测模型。方法 选取2018年3月至2022年8月池州市人民医院手术治疗的226例四肢创伤骨折病人作为研究对象。应用Lasso分析筛选四肢创伤骨折病人术后低蛋白血症的预测因素,应用logistic回归分析筛选四肢创伤骨折病人术后低蛋白血症的危险因素,应用R软件构建四肢创伤骨折病人术后低蛋白血症的列线图模型,并对四肢创伤骨折病人术后低蛋白血症的列线图模型进行验证。结果 logistic回归分析结果显示,女性、年龄≥65岁、术中出血量≥300 mL、胃肠功能损伤、肺部感染、术前白蛋白<35 g/L、衰弱、输注胶体液及蛋白等是四肢创伤骨折病人术后低蛋白血症的危险因素(P<0.05)。四肢创伤骨折病人术后低蛋白血症的列线图模型的校正曲线显示预测值与实际值的拟合度较好;模型的AUC是0.84[95%CI:(0.80,0.87)];决策曲线显示阈值概率在2%~75%范围内时,应用该列线图预测四肢创伤骨折病人术后低蛋白血症净获益值较高。结论 女性、年龄≥65岁、术中出血量≥300 mL、胃肠功能损伤、肺部感染、术前白蛋白<35 g/L、衰弱、输注胶体液及蛋白等是四肢创伤骨折病人术后低蛋白血症的危险因素,本研究基于以上8项危险因素构建的列线图能够对四肢创伤骨折病人术后低蛋白血症的防治工作起到帮助作用。

胃肠道肿瘤患者术后低蛋白血症的相关危险因素分析和预测模型建立

目的:旨在筛选胃肠道肿瘤术后低蛋白血症的围术期相关危险因素,并建立相应预测模型。方法:回顾性分析2022年12月至2023年6月在我院行胃肠道肿瘤根治术的244例患者临床资料,运用Logistic回归分析对术后低蛋白血症的相关因素进行单因素和多因素分析,筛选出独立危险因素;并建立Nomogram预测模型,评估其预测价值。结果:研究结果显示,共计125例患者术后出现低蛋白血症,占比54.8%。多因素Logistic回归分析显示:术前白蛋白水平(OR 0.70,P<0.01)、BMI(OR 0.79,P<0.01),术中激素(OR 0.92,P<0.01)、白蛋白使用量(OR 0.72,P<0.01),术毕血糖(OR 1.54,P<0.01)和复合硬膜外麻醉(OR 0.38,P<0.05)为术后低蛋白血症发生的独立危险因素。预测模型ROC曲线下面积为0.848(95%CI 0.800~0.896),预测价值较好。结论:术前白蛋白水平、BMI,术中激素、术中白蛋白使用量,术毕血糖和复合硬膜外麻醉是术后低蛋白血症发生的独立危险因素,基于上述变量的Nomogram列线图预测模型具有较高的预测效能,可为临床决策提供有效参考。

Preoperative Corticosteroid Usage and Hypoalbuminemia Increase Occurrence of Short-term Postoperative Complications in Chinese Patients with Ulcerative Colitis

Background： Clarifying the risk factors for postoperative complications and taking measures to minimize these complications will improve the outcomes in patients with ulcerative colitis （UC）.This study aimed to systemically explore the risk factors for short-term postoperative complications in Chinese UC patients undergoing ileocolorectal surgery.Methods： Forty-nine UC patients undergoing proctocolectomy or ileostomy were retrospectively enrolled.Univariate and multivariate logistic regression analyses were conducted to reveal the risk factors among the clinical, laboratory, and surgical variables as well as preoperative medications.Results： Twenty-two （44.9%） patients who suffered from at least one short-term postoperative event had more severe hypoalbuminemia （P =0.007） and an increased prevalence of preoperative corticosteroid usage （prednisone more than 20 mg daily or equivalent） for more than 6 weeks （59.1% vs.25.9%, P =0.023） compared with patients without short-term postoperative complications.Based on the multivariate logistic regression analysis, the odds ratio （95% confidence interval） values of these two risk factors were 1.756 （0.889-3.470, P =0.105） and 3.233 （0.916-11.406, P =0.068）, respectively.In 32 severe UC patients, prolonged preoperative hospital stay worsened the short-term postoperative outcomes.Conclusions： Preoperative corticosteroids usage and hypoalbuminemia worsened the short-term outcomes following ileocolorectal surgery in Chinese UC patients.

Is correction of severe hypoalbuminemia necessary in the critically ill？

The rationale for using albumin in the critically ill intensive care unit （ICU） patient showing hypoalbuminemia is to increase colloid oncotic pressure （COP） to prevent extravasation of fluid from the intra- to the extravascular space. Correction of low albumin plasma levels is also justified by the role of albumin for binding and transportation of drugs and for its possibly beneficial role as an oxygen radical scavenger.

应用托伐普坦治疗糖尿病肾病综合征所致顽固性水肿个案分析

糖尿病肾病综合征(diabeticnephropathysyndrome,DNS)是一种非免疫因素介导的继发性肾病综合征。由于其发病为非免疫因素介导,此类患者应用激素治疗无效,导致其引起的水肿在治疗上更加依赖利尿剂。新型利尿剂托伐普坦是一种选择性血管加压素V2受体拮抗剂,其发挥作用不依赖于白蛋白,目前主要用于减轻肝硬化、心力衰竭、抗利尿激素分泌异常综合征等导致的水肿,还可用于常染色体显性多囊肾病的辅助治疗,但在DNS患者中的应用较少。本文通过分享应用托伐普坦治疗1例顽固性水肿的DNS患者的经过,探讨托伐普坦治疗DNS患者的效果、安全性及未来前景。

重度子痫前期并发心功能不全的危险因素分析

目的探究重度子痫前期(severe preeclampsia,sPE)出现心功能不全相关的危险因素。方法选取2020年1月至2023年9月于温州市中心医院住院的sPE并发心功能不全的患者32例作为实验组,并随机选取同时期心功能正常的sPE患者75例作为对照组。比较两组患者的一般资料和实验室指标的差异,采用二元Logistic回归分析探讨sPE出现心功能不全的危险因素。结果实验组患者出现呼吸衰竭、血管内溶血-肝酶升高-低血小板、感染的例数高于对照组,差异有统计学意义(P<0.05)。对照组发生新生儿窒息、新生儿转重症监护的例数高于实验组,差异有统计学意义(P<0.05)。两组患者的孕前体质量指数、孕期体质量增幅、血钙、白蛋白、血红蛋白、双胎、感染差异有统计学意义(P<0.05),二元Logistic回顾分析结果显示,孕前体质量指数增加、孕期体质量增幅≥20kg、低血钙、低白蛋白、中度贫血、孕期血压增加是sPE出现心功能不全的危险因素。结论孕期应积极控制血压、补钙、补铁、补充白蛋白、控制体质量;对sPE患者增加血钙、白蛋白、血红蛋白、血压相关指标监测的频率,积极控制血压、解痉、预防感染可减少sPE患者心功能不全的发生。

冠状动脉旁路移植术后低清蛋白血症危险因素与预后

目的探讨冠状动脉旁路移植术(CABG)后低清蛋白血症的危险因素及临床预后。方法回顾分析CABG病人483例,定义术后第1天血清清蛋白(ALB)水平较术前下降的差值为△ALB,将△ALB≤7 g/L病人97例归为A组、7 g/L<△ALB≤15 g/L病人298例归为B组、△ALB>15 g/L病人88例归为C组。比较3组病人术前、术中、术后相关资料及术后随访36个月主要不良心血管事件(MACE)发生情况。结果C组合并高尿酸血症的病人数及左室射血分数<40%的病人数高于A、B两组,差异有统计学意义(χ^(2)=6.802~6.857,P<0.05);B、C两组中有介入治疗(PCI)史的病人数高于A组,差异有统计学意义(χ^(2)=8.193,P<0.05);C组术后在ICU停留时间>72 h、CABG当天引流>400 mL、大量失血、输注红细胞、输注血浆、肾损伤等病人占比明显高于A、B两组,差异有统计学意义(χ^(2)=6.741~39.287,P<0.05);C组术后MACE事件发生率高于A、B两组,差异有统计学意义(χ^(2)=8.205,P<0.05)。Cox回归分析中校正多种混杂因素后,病人术前有PCI史(OR=1.670,95%CI=1.091~2.556,P=0.018)及左室射血分数<40%(OR=4.468,95%CI=2.304~8.665,P<0.001)是术后ALB水平减低的独立危险因素,CABG后第1天ALB水平较术前下降程度7 g/L<△ALB≤15 g/L(OR=2.784,95%CI=1.190~6.516,P=0.018)和△ALB>15 g/L(OR=3.487,95%CI=1.373~8.853,P=0.009)是远期MACE的独立预测因素。结论PCI史及左室射血分数<40%是CABG后ALB水平减低的独立危险因素,术后第1天ALB水平较术前下降>7 g/L是CABG预后的预测因素。

腹腔镜结直肠癌根治术后动力性肠梗阻发生情况及高危因素分析

目的探讨结直肠癌患者腹腔镜下根治术后动力性肠梗阻发生现状及影响因素。方法选取2020年2月-2023年4月我院收治的80例腹腔镜下结直肠癌根治术患者,根据术后是否发生动力性肠梗阻分为两组。收集患者性别、年龄、体重指数、文化程度、肿瘤位置、TNM分期、分化程度、术前是否有肠梗阻、腹部手术史、合并贫血、淋巴结转移、低蛋白血症、肿瘤直径、手术时间、吸烟酗酒史等资料。对一般资料进行单因素分析,再对有统计学差异因素的进行多因素Logistic回归分析。结果80例腹腔镜下结直肠癌根治术患者,18例动力性肠梗阻,发生率22.50%;单因素分析显示,两组TNM分期、术前是否有肠梗阻、腹部手术史、术前是否合并贫血、是否淋巴结转移、术前是否有低蛋白血症比较,差异有统计学意义(χ^(2)=18.148、7.681、8.119、10.904、9.395,P=0.000、0.003、0.006、0.0.05、0.001);Logistic回归分析TNM分期为Ⅲ期、术前有肠梗阻、有腹部手术史等是影响腹腔镜下结直肠癌根治术后动力性肠梗阻发生的独立危险因素(P<0.05且OR>1)。结论直肠癌患者腹腔镜根治术后动力性肠梗阻发生与TNM分期为Ⅲ期、术前有肠梗阻等有关,及时制定针对性预防措施,从而减少动力性肠梗阻。

Preoperative hypoalbuminemia is associated with an increased risk for intra-abdominal septic complications after primary anastomosis for Crohn’s disease

Objective:The aim of this study was to evaluate the impact of preoperative hypoalbuminemia on the development of intraabdominal septic complications(IASCs)after primary anastomosis for patients with Crohn’s disease(CD).Methods:All CD patients undergoing bowel resection with a primary anastomosis during the study period from 2007 to 2015 were enrolled.The association of preoperative hypoalbuminemia(<30 g/L)with the risk for IASCs were assessed using both univariate and multivariate analyses.Results:A total of 124 eligible patients were included,117(94.4%)of whom had available preoperative albumin level.Preoperative hypoalbuminemia occurred in 13(11.7%)patients.The duration fromdiagnosis to surgery was longer for patients with preoperative hypoalbuminemia than those without(p=0.012).Patients with preoperative hypoalbuminemia weremore likely to have a history of preoperative use of 5-aminosalicylic acid(p=0.013)and have an intraoperative finding of small bowel obstruction(p=0.015).Of all patients,24(19.4%)developed postoperative IASCs.Univariate analysis showed that patients with preoperative hypoalbuminemia had an increased risk for IASCs(p=0.012).Multivariate analysis confirmed the association between preoperative hypoalbuminemia and IASCs(odds ratio 4.67,95%confidence interval:1.28–17.04,p=0.02).Similar findings were also obtained when preoperative albumin level was analysed as a continuous variable(p=0.019).Conclusions:Preoperative hypoalbuminemia is a significant predictor for the development of postoperative IASCs in CD patients after bowel resection with a primary anastomosis.Favorable preoperative nutrition status might lessen the risk for IASCs.

脑卒中后吞咽障碍病人低蛋白血症的影响因素

目的:分析脑卒中后吞咽障碍病人低蛋白血症的影响因素。方法:对我院2021年1月—12月住院的150例脑卒中后吞咽障碍病人的临床资料进行回顾性分析,根据是否发生低蛋白血症分为低蛋白血症组和无低蛋白血症组,通过单因素分析法和Logistic回归分析对脑卒中后吞咽障碍病人发生低蛋白血症的影响因素进行分析。结果:150例脑卒中后吞咽障碍病人发生低蛋白血症61例,无低蛋白血症89例,低蛋白血症发生率为40.67%。单因素分析结果显示,两组在年龄、日常生活活动能力(ADL)评分、意识障碍、肺部感染、留置胃管、洼田饮水试验分级比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高龄、低ADL评分、意识障碍、肺部感染、留置胃管、洼田饮水试验分级≥Ⅲ级是脑卒中后吞咽障碍病人低蛋白血症的独立危险因素。结论:高龄、低ADL评分、意识障碍、肺部感染、留置胃管、洼田饮水试验分级≥Ⅲ级是脑卒中后吞咽障碍病人发生低蛋白血症的独立危险因素。