足够能量和蛋白质摄入不能改善住院老年卧床患者血清白蛋白水平

摘要

Objective To study the effects of energy and protein intake on serum albumin level in bedridden old male inpatients. Methods Clinical data about 37 bedridden old male patients in our hospital were retrospectively analyzed. They were allocated into low serum albumin(LA) group(serum albumin<35g/L, n=22) and normal serum albumin(NA) group(serum albumin ≥ 35g/L, n=15). Energy and protein intake, nitrogen balance, hemoglobin level and lymphocytes were compared between the two groups. Results No significant difference was observed in energy and protein intake between the two groups(22.42 ± 4.62kcal/(kg · d) (lkcal=4.184J) and (0.99 ± 0.23)g/(kg · d) vs (22.37 ± 4.25)kcal/(kg · d) and (0.92 ± 0.18)g/(kg · d)), but the nitrogen balance value and hemoglobin level were significantly lower in LA group than in NA group((-1.17 ± 2.35) and (108.23 ± 12.07)g/L vs (1.07 ± 1.46) and (123.87 ± 18.97)g/L, P<0.05). The percentage of patients with negative nitrogen balance and anemia was significantly higher in LA group than in NA group(59.1% and 63.8% vs 26% and 20%, P<0.05). Conclusion Sufficient energy and protein intake cannot improve the serum albumin level in bedridden old male inpatients. Patients with hypoalbuminemia are easy to have complications of negative nitrogen balance and anemia. The reasons of hypoalbuminemia need to be further studied.%目的 了解能量和蛋白质摄入对住院老年男性卧床患者血清白蛋白水平的影响.方法 采用回顾性方法选取37 例我院住院老年男性卧床患者( 肝肾功能不良者除外),按血清白蛋白水平分为:低白蛋白组(low serum albumin,Albumin<35g/L,LA组,n=22) 和白蛋白正常组(normal serum albumin,albumin ≥35g/L,NA 组,n=15),比较两组能量和蛋白质摄入量、氮平衡、血红蛋白和淋巴细胞等指标.结果 虽然LA 组能量[(22.42±4.62)kcal/kg·d](1kcal=4.184J) 和蛋白质摄入(0.99±0.23)g/kg·d]与NA 组能量[(22.37±4.25)kcal/(kg·d)] 和蛋白质摄入[(0.92±0.18)g/(kg·d)] 相比无统计学差异(P>0.05),但LA 组氮平衡数值(-1.17±2.35) 和血红蛋白水平[(108.23±12.07)g/L] 明显低于NA 组[(1.07±1.46)、(123.87±18.97)g/L] ;LA 组负氮平衡患者所占比例(59.1%,13/9) 和贫血患者所占比例(63.8%,14/8) 明显高于NA 组[(26%,4/11)、(20%,3/12)].结论 足够能量和蛋白质摄入不能提高住院的老年男性卧床患者血清白蛋白水平,低白蛋白患者更易合并贫血和负氮平衡,血清白蛋白降低原因需进一步研究.