血清前白蛋白变化作为手术瘤患者中平衡的标志物
Jacob W Hall1, Todd W Canada2, Paul F Mansfield3
1The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 377, Houston, TX, 77030, USA. jhall1@mdanderson.org.
概括
血清前白蛋白 (蛋白质) 水平的积极变化可以表明在接受亲肠道营养 (PN) 的手术癌症患者中,平衡是正的. 然而,它的低特异性限制了其用于预测负余量的使用.
科学领域:
- 生物化学 生物化学
- 临床营养学 临床营养学
- 在瘤学瘤学.
背景情况:
- 血清前白蛋白是一种营养标记物,但受炎症,手术和癌症的影响.
- 之前的研究将增加前白蛋白与一般手术患者的阳性平衡联系起来.
- 同时患有癌症和接受手术对前白蛋白对平衡的预测值的影响未被检查.
研究的目的:
- 评估血清前白蛋白在预测手术后癌症患者的平衡中的效用,这些患者接受了亲肠道营养 (PN).
- 在这个特定的患者群体中,评估前白蛋白水平和平衡变化之间的相关性.
主要方法:
- 对30名手术后患者 (≥19岁) 的回顾性分析,这些患者接受了PN5天以上.
- 在PN的5-10天之间测量了血清前白蛋白,C反应蛋白 (CRP) 和24小时尿液尿素 (UUN).
- 与平衡相关的前白蛋白变化,计算灵敏度,特异性和预测值.
主要成果:
- 前专辑蛋白 (>2.8 mg/dL) 的积极变化与积极的平衡 (p=0.02) 有显著关联.
- 这种变化显示了82%的灵敏度和62%的特异性,用于预测阳性平衡.
- 绝对前白蛋白水平受到炎症 (CRP升高) 的显著影响,无法可靠地预测平衡.
结论:
- 血清前白蛋白的积极变化 (>2.8 mg/dL) 显示出足够的灵敏度 (82%) 来预测PN的外科瘤患者的阳性平衡.
- 低特异性 (62%) 限制了其用于预测负平衡的常规使用.
- 绝对前白蛋白值是由于炎症而不可靠的预测指标;重点应放在动态变化上.
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