肠外营养治疗相关水溶性维生素循环蓄积的 危险因素分析

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中图分类号：R459.3 文献标志码：A DOI：10.11958/20242415

Abstract：ObjectiveTo explore influencing factors abnormal increase plasma water-soluble vitamins in patients with parenteral nutrition （PN）.MethodsAtotal86hospitalized patients receiving nutritional diagnosis and treatment wereenrolled.Dailywater-solublevitaminsupplyandtotal urine output were monitored.If patientsunderwent renal replacement rapy（RRT），ultrafiltrationvolumewasrecorded.Plasma concentrations ninewater-soluble vitamins （Vit-C，B，B，B，B5，B6，B7，B9andB）were measured.Accordingtotestresults，patients weredivided into accumulationgroupand non-accumulation group.Renalfunction （BUN，Cr，UA），inlammatory indicators （RP， WBC，NEU，SII）andnutritional idicators （ALB，PA，Hb，LYM）werecomparedbetweentwogroups.Logisticresio wasusedtoanalyze independentrisk factors accumulation water-soluble vitamins.ResultsTherewasahigh incidence abnormal plasmawater-solublevitamin levels，includingVit-B（ 6.08% ），Vit-B6（ 6.0% ）andVit-B5 （.8% ）.Compared with non-accumulation group， Vit-B accumulation group had higher levels age，BUN，Cr， UA and NEU，andlower levelsALB，PAandurine volume.TheVit-B5accumulation group had higherlevelsBUN，Cr， UA and NEU，and lower levels LYM，Hb，ALB，PAand urine volume.Patients in Vit-B6 accumulationgroup was older，with increased levelsBUN，Crand UA，anddecreased levelsLYM，Hb，ALB，urine volumeandvitaminintake （ P<0.05 ）.Multivariate Logistic regression analysis showed that elevated level BUN was independentrisk factors Vit-B accumulation， elevatedBUNandreducedurine volume were independentrisk factors Vit-B5accumulation， andelevatedBUNandCr，aswellasreducedurine volume，were independentriskfactorsVit-B6accumulation.Receiver operatingcharacteristiccurveanalysis showed that area under curve BUNin predicting Vit-B，B5and B6 accumulationwere0.659 （95%CI：0.60-0.697），0.78 （95%CI：0.675-0.78）and0.785（95%CI： 0.78-0.8）， respectively，withhighspecificitybutlowsensitivity.ConclusionTheserumlevelswater-solublevitaminsareffected byrenal function.When implementing parenteral nutritionwater-soluble vitaminssupplementation， patient'srenal functionstatusshouldbeevaluated，andriskabnormalelevationVit-B，B5andB6shouldbevigilantlyoitored.

Words： vitamins; riblavin; pantonic acid; vitamin B 6; parenteral nutrition; accumulation

维生素是机体不能合成或合成量不足时必须通过外源补充的一类必需的微量营养素，参与机体多种生化代谢过程[-]。（剩余6790字）