摘要目的 探讨血清白蛋白(ALB)水平对晚期早产儿感染预后的预测价值.方法 回顾性分析2012年7月至2013年7月我院儿科新生儿监护室收治的晚期早产儿(胎龄34～36周)完整临床资料,包括相关实验室检查指标、新生儿危重病例评分(NCIS)、围产期合并症、转归等;根据血清 ALB 水平,将所有纳入新生儿分为＞30 g/L、25 ～30 g/L、＜25 g/L 3 组.结果 共纳入257例晚期早产儿, ALB 水平＜25 g/L 组122 例,占47.4％.新生儿脓毒症32 例,新生儿感染190例,非新生儿感染35例,3组低白蛋白血症发生率分别为84.4％、50.0％、28.6％,病死率分别为15.6％、0.5％、0 ,脓毒症组低白蛋白血症发生率和病死率高于感染组和非感染组(P＜0.05) ,感染组和非感染组差异无统计学意义(P＞0.05).存活组ALB水平高于死亡组[ (29.6 ± 7.5)比(20.4 ± 6.9)g/L],差异有统计学意义(P＜0.05).ALB＜25 g/L组NCIS单项危重病例比例和脏器损伤≥4个的比例分别为65.5％和26.2％,单项危重病例比例高于其余两组,脏器损伤≥4个的比例高于＞30 g/L组,差异有统计学意义(P＜0.05).结论 新生儿脓毒症患儿低白蛋白血症发生率高,患儿血清ALB水平与预后关系密切.ALB水平测定对新生儿早期感染预后有良好的评估价值.

abstractsObjective To study the value of serum albumin ( ALB ) level for the prognosis of late-preterm infants infection. Methods Late-preterm infants admitted to the neonatal intensive care unit ( NICU) from July 2012 to July 2013 were recruited and their clinical data retrospectively reviewed, including the laboratory examination results, neonatal critical illness scores ( NCIS ) , perinatal complications and prognosis. The infants were assigned into three groups based on ALB levels (＞30 g/L, 25-30 g/L, ＜25 g/L). Results A total of 257 cases were recruited and 122 cases (47. 4％) had ALB levels ＜25 g/L. 32 had neonatal sepsis ( sepsis group) , 190 neonatal infection ( infection group) and 35 without infection ( no-infection group ) . The incidences of hypoalbuminemia among these groups were 84. 4％, 50. 0％ and 28. 6％, with the mortality rate 15. 6％, 0. 5％ and 0％. The incidence of hypoalbuminemia and mortality rate in sepsis group were significantly higher than the other groups ( P＜0. 05 ) , and no statistically significant differences between infection group and no-infection group ( P＜0. 05). The ALB level in survived infants [(29. 6±7. 5)g/L] was statistically higher than the deceased ones [(20. 4±6. 9)g/L](P＜0. 05). The incidence of critically ill newborns was 65. 5％ in ALB ＜25 g/L group, significantly higher than the other groups (P＜0. 05). 26. 2％ in ALB ＜25 g/L group had more than 4 organs injuries, significantly higher than ALB ＞30 g/L group ( P＜0. 05 ) . Conclusions Hypoalbuminemia is common among neonates with sepsis. The ALB level had predictive value for the prognosis of neonatal infection.