Department of Anaesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, D-67063 Ludwigshafen, Germany.
Br J Anaesth. 2010 Mar;104(3):276-84. doi: 10.1093/bja/aep393. Epub 2010 Jan 24.
Human albumin (HA) is widely used for volume replacement or correction of hypoalbuminaemia. The value of HA in the clinical setting continues to be controversial, and it is unclear whether in today's climate of cost consciousness, there is still a place for such a highly priced substance. It is therefore appropriate to update our knowledge of the value of HA. With the exception of women in early pregnancy, there appears to be few indications for the use of HA to correct hypovolaemia. Some studies of traumatic brain injury and intensive care patients suggest negative effects on outcome and organ function of (hyperoncotic) HA. Modern synthetic colloids appear to be a cheaper alternative for maintaining colloid oncotic pressure. The value of using HA to correct hypoalbuminaemia has not been clearly justified. Theoretical and pharmacological benefits of HA, such as oxygen radical scavenging or binding of toxic substances, have not as yet been shown to have beneficial clinical consequences. Experimental data from cell lines or animals do not appear to mimic the clinical setting. Convincing data justifying the use of HA either for treating hypovolaemia or for correcting hypoalbuminaemia are still lacking. A restricted use of HA is recommended.
人血白蛋白（HA）被广泛用于容量替代或低白蛋白血症的纠正。HA 在临床环境中的价值仍然存在争议，在当今注重成本的环境下，是否仍然需要使用这种高价位的物质尚不清楚。因此，更新我们对 HA 价值的认识是恰当的。除了早期妊娠的妇女外，似乎很少有使用 HA 纠正低血容量的指征。一些颅脑损伤和重症监护患者的研究表明，（高渗性）HA 对结局和器官功能有负面影响。现代合成胶体似乎是维持胶体渗透压的更便宜的替代品。使用 HA 纠正低白蛋白血症的价值尚未得到明确证实。HA 的理论和药理学益处，如清除氧自由基或结合有毒物质，尚未显示出有益的临床后果。细胞系或动物的实验数据似乎与临床情况不符。没有令人信服的数据证明 HA 用于治疗低血容量或纠正低白蛋白血症是合理的。建议限制使用 HA。
