血清白蛋白、前白蛋白、视黄醇结合蛋白及转铁蛋白在胃癌术后肠外营养支持中的意义

摘要

目的 研究血清白蛋白(ALB)、前白蛋白(PA)、视黄醇结合蛋白(RBP)、转铁蛋白(TRF)在胃癌术后患者肠外营养支持中的营养监测价值.方法 选择2016年6月～2017年6月青岛大学附属医院胃肠外科行胃癌手术的患者80例,所有患者于胃癌手术后第1天开始全肠外营养支持(≥5d).分别收集入院常规检查时(术前)、术后第1天、术后第6天的血清标本,并检测血清ALB、PA、RBP以及TRF水平的变化.结果 ①术前、术后第1天、术后第6天,血清ALB 、PA、RBP以及TRF的浓度比较,差异有高度统计学意义(P＜0.01);②术后第1天,血清ALB、PA、RBP以及TRF较术前均下降,差异有高度统计学意义(P＜0.01);③术后第6天,血清ALB、PA、RBP以及TRF较手术后第1天均升高,差异有高度统计学意义(P＜0.01);④术后第6天,PA、RBP与术前比较,差异无统计学意义(P＞0.05),ALB、TRF与术前比较,差异有统计学意义(P＜0.05).结论 血清ALB、PA 、RBP以及TRF可以反映患者营养状况,对胃癌术后患者应用肠外营养支持有一定指导作用.%Objective To study the nutritional monitoring value of serum albumin (ALB),prealbumin (PA),retinol binding protein (RBP),and transferrin (TRF) in parenteral nutrition support for patients after gastric cancer surgery.Methods From June 2016 to June 2017,80 patients with gastric cancer surgery stayed in the Gastrointestinal Surgery,the Affiliated Hospital of Qingdao University were selected,and they were started with total parenteral nutrition (TPN) (≥5 d) on the first day after gastric cancer surgery.The serum specimen of blood routine examinations on the day of hospital admission (before surgery),on the first day and the sixth day after surgery were collected respectively,and changes of ALB,PA,RBP and TRF level in serum were measured respectively as well.Results ①Concentration changes of ALB,PA,RBP and TRF before surgery,on the first day after surgery and the sixth day after surgery were comparerd,the differences were statistically significant (P ＜ 0.01).②On the first day after surgery,ALB,PA,RBP and TRF dropped compared with before surgery,the differences were statistically significant (P ＜ 0.01).③On the sixth day after surgery,ALB,PA,RBP and TRF climbed up compared with the first day after surgery,the differences were statistically significant (P ＜ 0.01).④On the sixth day after surgery,PA and RBP were compared with before surgery,the differences were not statistically significant (P ＞ 0.05),and ALB and TRF were compared with before surgerv,the differences were statistically significant (P ＜ 0.05).Conclusion Serum ALB,PA,RBP and TRF can reflect patients' nutritional status and they play a guiding role in parenteral nutrition support for patients after gastric cancer surgery.