重症脑出血病人危重程度与营养指标间的相关性研究

为探讨重症脑出血患者危重程度与应激时营养代谢变化之间的关系，以ＡＰＡＣＨＥⅡ评分系统作为疾病危重程度的评估标准，用多元相关与多元逐步回归的方法分析重症脑出血病ＡＰＡＣＨＥⅡ评分与上臂肌围、上臂皮折厚度、肌酐身高指数、血清白蛋白、血清转铁蛋白、全血淋巴细胞计数、氮平衡等７ 项营养指标间的关系。结果：共完成测试病人３８ 例，ＡＰＡＣＨＥⅡ评分与血清白蛋白、血清转铁蛋白、肌酐身高指数、氮平衡之间相关性较高，且具有统计学意义（Ｐ＜ ０．０５）。与上臂肌围、上臂皮折厚度、全血淋巴细胞计数之间相关性较低（ Ｐ＞ ０．０５）。其中氮平衡、血清转铁蛋白、血清白蛋白进入回归方程。结论：重症脑出血病人的危重程度与应激时蛋白代谢之间有一定的因果关系，故营养代谢支持，特别是应激状态下氮的补充应是重症监护治疗中的重要组成部分

THE CORRELATION OF THE CRITICAL DEGREE OF SERIOUS CEREBRAL HEMORRHAGE PATIENTS WITH THEIR NUTRITION ASSESSMENT INDEX

To discover the relationship between the critical degree of serious cerebral hemorrhage patients and the change of their nutrition assessment index in stress, and provid some basis for early metabolish support for these patients,We used the APACHE Ⅱ system as the standard to assess the patients serous degree and then used multiple correlation analysis and mutiple stepwise regression to analyse the correlation of the patients' APACHE Ⅱ score and their nutrition index,including AMC,TSF,ALB,TFN,CHI,TLC and nitrogen balance,The results showed that the total diseased were 38 cases.The APACHE Ⅱ score has a high correlation with ALB,TFN,CHI and N Balance (P<0.05), and has a low correlation with AMC,TSF and TLC (P>0.05).Among them,ALB TFN and N Balance go into the regression equation.The critical degree of serious cerebral hemorrhage patients have certain causality with the patient's protein metabolism in stress.Nutrition support in stress is an important part in serious cerebral hemorrhage treatment.