129 *+,- $./,01. 2 34567689:; 吴斌林知微陈冯秀 2 345676, <=> 2 $./,01.?@ AB 2013 3 C 2014 4 "#$%&' # $ DE 867 2,FG2 HIJ 24hKLM $./,01.,NO. M.,0 :.,0,- BPQ3RS34567689TU V 2 WX Y 2 5 Z[\,]^ _`B2 ab:c 8.,0 463 (53 4%).,0 404 (46 6%);.,0.,0 2 345676 X (144 7±50 6)mg/LT (173 6±71 3)mg/L, G &; (t=6 795,P=0 000); > 2 Y J 5 6 3676 C 76, 2 345676 H@:= 95% CI X 139 8(134 9~144 8)mg/LT 157 9(151 9~163 8)mg/L,.,0 2 345676 + I.,0 (F=20 433,P=0 000).,0] 345676.,0 345676:.,0 345676 2 D X 62 9% (95/151) 80 5% (251/312) 77 1% (27/35) : 98 1% (362/369) (χ 2 =112 80,P=0 000),# K W X 21 9% (33/151) 8 7% (27/312) 22 9% (8/35): 1 9% (7/369)(χ 2 =63 55,P=0 000) 2 RS,0./1 - RS34567689, 2 >,0,0; $2./,01 ;5676; PrealbuminmeasurementinhospitalizedchildrenwithdiferentscoreofScreeningToolfortheAses mentofmalnutritioninpediatricsanditsvalue WuBin,LinZhiwei,ChenFengxiu.DepartmentofPedi atrics,thefirstafiliatedhospitaloffujianmedicaluniversity,fuzhou350005,china Corespondingauthor:WuBin,E mail:wbdnch@163.com Abstract Objective Toinvestigatethediferenceofserumprealbumininhospitalizedchildren anditsvalueinscreeningtoolfortheassessmentofmalnutritioninpediatrics(stamp)inhospital izedchildren.methods 867hospitalizedchildrenwererecruitedfrom March2013toApril2014in thefirstafiliatedhospitaloffujianmedicaluniversity.althepatientswereassessedusingstamp andcolectedvenousbloodsampleformeasuringserumprealbuminwithin24hoursafteradmission.al thepatientsweresurveyedforinformationregardinggender,age,dietarychanges,etc.andtheirclini caldataandlaboratoryresultsduringhospitalizationcolected.thepatientsweredividedintohighmal nutritionriskgroup(hmrg) andlowmalnutritionriskgroup(lmrg) accordingtostampscores uponadmission. Results Therewere463 children (53 4%) in HMRG, and404 in LMRG (46 6%).ComparedwiththeLMRG,theHMRGhadsignificantlylowerserumprealbumin[(144 7± 50 6) mg/lvs.(173 6±71 3) mg/l,t=6 795,P=0 000].Aftercontrolingforage,course ofdisease,whitebloodcelcount,albumin,glutamic oxalacetictransaminase,c reactiveproteininco DOI:10.3760/cma.j.isn.1674 635X.2016.03.001 :350005!, "#$%&' # $ :(),E mail:wbdnch@163.com
130 2016 6 24 3 varianceanalysis,thehmrgstilhadsignificantlylowerserum prealbuminthanthelmrg[estimate (95% CI):139 8 (134 9-144 8) mg/lvs.157 9 (151 9-163 8) mg/l,f=20 433, P=0 000).ClinicalcureratesinHMRGwithlowserumprealbumin,HMRGwithnormalserumpre albumin,lmrgwithlowserum prealbumin,andlmrgwithnormalserum prealbuminwere62 9% (95/151),80 5% (251/312),77 1% (27/35),and98 1% (362/369) (χ 2 =112 80, P=0 000),respectively;incidencesofhospitalacquiredinfectionwere21 9% (33/151),8 7% (27/312),22 9% (8/35), and1 9% (7/369) (χ 2 =63 55, P =0 000), respectively. Conclusion Highmalnutrtioncouldbedistinguishedmoreaccuratelyusingthecombinationoftheas sessmentofmalnutritionscreeningtoolsandserum prealbuminmeasurement. Keywords Nutritionalrisk;ScreeningToolfortheAsesmentofMalnutritioninPediatrics;Prealbu min;children 2,0,0,,01 J 2 RS,01 X,02,:,,0 [1 2] G 345 676 (prealbumin,pa) I 76 676,8934 PA.? 0 [3 5] 2 34 PA, <=> 2, 0.?@ 1 1 1 AB 2013 3 C 2014 4 "#$%& ' # $ DE 2 867, - 2 61 7% (867/1406);= 539 (38 3%) - RS,0./T3456 7689 3d DE 5 3 676 : 38 J 867 2 Y 30d~13,Y 3 34 ; 303 (34 9%) 564 (65 1%) 867 2,!" # 332 $%&'" # 210 " # 185 W# 76 " # 53 =(# 11 1 2./,01. ) FG J 2 H>J 24h KLM $./,01 (ScreeningTool for the AsesmentofMalnutrition in Pediatrics, STAMP). [2] STAMP. *+#, -J T 3., / 3.. 0 1,NO2 # 2,0 (0 ) >,0 (2 ) 3 / >,0 (3 );=, 2 := 456 U V, 7 -J RS., 2 -J0 0 -J 89 : 2 2-J 3 ;-, J 2 RS : 9, 9 ; % $ (kg) 9 ] <C 0 1kg; : ; 9 =: 9 > 9, <C 0 1cm,N O WHO?,; Z@. ), @ YX Z@, @ RS., -2< Z<2 A 0-3<Z -2 2 Z<3 A 2 Z -3 Z 3 A 3 ;B,3.. 01CT STAMP, 4.,0, <4.,0 STAMP. D E%0 $# LM 1 3 U V FG H>J 24hKLMU V, V K *+2 E WX Y 2 5 Z[ (F :G G H );]^ _`B2 ab:c 8 1 4 34 PA89 FG J 24hKIJ;BPQ3 1mlK 8 $89,; LM N)RS34 PA8 9 8 9 = O / 7 6 = BN Ⅱ (MY 003),PA9/ PQ # & RS ( T) GUVW NOXKY 34 PA @ [3], 2 34 PA 89 RS.? 1 5 & ; SPSS17 0 Z[RS, O
131 ; H ±? \],; ^_` t8 T P<0 05 G &; 2 2 1 867 2,735 (84 8%) D,132 (15 2%),2 1 a b; c (10 3±8 0) d,75 (8 7%)2 # K W,=! 53 17 5 NO STAMP.,867 2,.,0 463 (53 4%).,0 404 (46 6%), 2 D X 74 7% (346/463) 96 3% (389/404),# K W X 14 9% (60/463) 3 7% (15/404), HG &; (χ 2 =77 679,χ 2 =23 341;PH <0 01) 2 2.,0 T.,0 2 34 PA89.,0.,0 34 PA X (144 7±50 6)mg/LT (173 6± 71 3)mg/L, G &; (t= 6 795,P=0 000) 2 3.,0 T.,0 2 34 PA,-Y2 =34 PA,-, :, -2 = \H >, M 2 34 PA@,,, 34 PA@,2 Y J 5 J 5 6 W W 3 76 H 3676 3c 3 3 C 76 3, 36, 6\ 34 PA89, RS, 2 34 PA ], 2 34 PA 2 Y (F=16 983, P=0 000) J 5 (F =11 125, P = 0 001) 6 (F=8 252,P=0 004) 36 76 (F=3 821,P=0 048) (F= 3 865,P=0 047) : C 76 (F=48 805, P=0 000),>,,.,0 T.,0 2 34 PA @ (95% CI) X 157 9 (151 9~ 163 8)mg/LT 139 8(134 9~144 8)mg/L, G & ; (F =20 433, P = 0 000) 2 4 STAMP. 34 PA89 867 2,34 PA 681 (78 5%) 34 PA 186 (21 5%) 2 D X 90 0% (613/681) 65 6% (122/ 186),# K W X 5 0% (34/681) 22 0% (41/186), G &; (χ 2 =67 519,P=0 000;χ 2 =53 748, P=0 000) / STAMP. 34 PA89 RS ],.,0] 34 PA.,0 34 PA:.,0 3 4 PA 2 D X 62 9% (95/151) 80 5% (251/312) 77 1% (27/35): 98 1% (362/369) (χ 2 =112 80,P= 0 000),# K W X 21 9% (33/151) 8 7% (27/312) 22 9% (8/35) : 1 9% (7/369)(χ 2 =63 55,P=0 000) 3 5X 2./,0 1,*+ ; STAMP.,,2, 01 L I 2,% >, T,^ 2,0./ [2]?< 2,,.,,,01,, G ; PA K 76,=> M, : 48h 34 PA89,,., 89 ;-,34 PA -J, -J,34 PA M, -J, 3d,34 PA + [5], 34676\ 0,34 PA < :B7 -J, G W W, M W49. : E.? [3 5] Ong\ [3], I6 9 & UW,34 PA
132 2016 6 24 3 \, 3 &8., T0, % I.?2 -J,, >#, X >, Devoto\ [4],. 76,0?, 34 PA W WB,34 PA.,0 S Rocha\ [4],34 PA9/.? 2 2 76,0 Saka\ [6],34 PA,0 1 2002G0 W, 34 PA 9,0, I >RS 2 49 Robinson\ [7] > & # 320 2 RS,0 1 T34 PA8,104 (33%) >G., 0, RS.,0,F H 3d;142 (43%).,0 R RS.,162 (51%)34 PA,,0, RS,0./ RS. F 1 2d,-,142.,02 G 71 (50%) 34 PA,,0;,,01.,02,^. 2 : RS Bae\ [8],PA 2 ] 52%,PA 24%; ] ( X ] ) 5 PA 0,PA ] ^_,, 5 PA ] G?@ 9, X ] G&,.? 5,01 G W,PA, I89, 01 T, 0. / [3,9] STAMP..,02 34 PA + I.,02,> 34 PA =(,,.,02 34 PA + I.,02 34 PA 2 0, 34 PA2 D, # K W, ; STAMP. 0 STAMP. 34 PA89 0 RS.? ],.,0] 3 4 PA2 D B,# K W, G34 PA 2, STAMP..,0, = ] 34 PA.,02 `,D, C=# K W B XK Y [3 8],D,3 4 PA:, I 76,,34 PA,, ]34 PA, ],0, M ] >, 2 34 PA@, ] 2 >,0 ;-, 34 PA.? 2, = 3 4 = (,,,, /34 PA89,0.? [3,6],,01 RS.?,, X >,0 2, J 2 RSU V!, 01,- RS34 PA89, ^; U V!,0 1 UW,?< 1 >,0 2,^ : R S./:,,0,"! " [1]JoostenKF,HulstJM.Prevalenceofmalnutritioninpediatrichos pitalpatients[j].curopinpediatr,2008,20(5):590 596. DOI:10.1097/MOP.0b013e32830c6ede. [2] McCarthyH,DixonM,CrabtreeI,etal.Thedevelopmentand evaluationofthescreeningtoolfortheasesmentofmalnutritionin paediatrics(stamp)forusebyhealthcarestaf[j].jhum Nutr Diet,2012,25(4):311 318.DOI:10.1111/j.1365 277X. 2012.01234.x. [3]OngC,HanWM,Wong J,etal.Nutritionbiomarkersandclini caloutcomesincriticalyilchildren:acriticalappraisalofthelit erature[j].clinnutr,2014,33(2):191 197.DOI:10.1016/j. clnu.2013.12.010. [4]DevotoG,GaloF,MarcheloC,etal.Prealbuminserumconcen trationsasausefultoolintheasesmentofmalnutritioninhospital izedpatients[j].clinchem,2006,52(12):2281 2285.DOI: 10.1373/clinchem.2006.080366. [5] RochaJC,AlmeidaMF,CarmonaC,etal.Theuseofprealbumin concentrationasabiomarkerofnutritionalstatusintreatedphenyl ketonuricpatients[j].annnutrmetab,2010,56(3):207 211.
133 DOI:10.1159/000276641. [6] SakaB,OzturkG,UzunS.Nutritionalriskinhospitalizedpatients: impactofnutritionalstatusonserumprealbumin[j].revnutr,2011, 24(1):89 97.DOI:10.1590/S1415 52732011000100009. [7] RobinsonMK,TrujiloEB,MogensenKM,etal. Improving nutritionalscreeningofhospitalizedpatients:theroleofprealbu min[j].jpen JParenterEnteralNutr,2003,27(6):389 395.DOI:10.1177/0148607103027006389. [8] BaeHJ,LeeHJ,HanDS,etal.Prealbuminlevelsasauseful makerforpredictinginfectionscomplicationsaftergastricsurgery [J].JGastrointestSurg,2011,15(12):2136 2144.DOI:10. 1007/s11605 011 1719 z. [9]#$, P%. &.,2015,23 (1):40,64. (' :2015 10 12 ) 櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒櫒 #$ %&' ()*+,-. #&Y` (EMBASE), X &Y` O := &Y` (CA), X ()$&Y` ( $&) [CSA (NatSci)],*+, -. / 0#&1 (WPRIM),X$& Y O (CSCD),X$ (X$ *Y ),X 2#&Y O