Philipps-Universität Marburg, Germany.
Nutrition. 2013 May;29(5):703-7. doi: 10.1016/j.nut.2012.10.014. Epub 2013 Jan 17.
Albumin plasma concentrations are being used as indicators of nutritional status and hepatic function based on the assumption that plasma levels reflect the rate of albumin synthesis. However, it has been shown that albumin levels are not reliable markers of albumin synthesis under a variety of clinical conditions including inflammation, malnutrition, diabetes mellitus, liver disease, and surgical tissue trauma. To date, only a few studies have measured albumin synthesis in surgical and critically ill patients. This review summarizes the findings from these studies, which used different tracer methodology in various surgical or critically ill patient populations. The results indicate that the fractional synthesis rate of albumin appears to decrease during surgery, followed by an increase during the postoperative phase. In the early postoperative phase, albumin fractional synthesis rate can be stimulated by perioperative nutrition, if enough amino acids are being provided and if nutrition is being initiated before the operation. The physiologic meaning of albumin synthesis after surgery, however, still needs to be further clarified.
血浆白蛋白浓度被用作营养状况和肝功能的指标，基于这样的假设：血浆水平反映了白蛋白合成的速度。然而，已经表明，在包括炎症、营养不良、糖尿病、肝病和手术组织创伤在内的多种临床情况下，白蛋白水平并不是白蛋白合成的可靠标志物。迄今为止，只有少数研究在外科和危重病患者中测量了白蛋白合成。这篇综述总结了这些研究的结果，这些研究在不同的外科或危重病患者人群中使用了不同的示踪剂方法。结果表明，白蛋白的合成率在手术后似乎会下降，然后在术后阶段会增加。在术后早期，如果提供了足够的氨基酸并且在手术前开始营养支持，那么围手术期营养可以刺激白蛋白的部分合成率。然而，手术后白蛋白合成的生理意义仍需要进一步阐明。
