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人血清白蛋白利尿疗法对晚期肝硬化患者腹水管理的贡献:一项前瞻性队列研究。

Contribution of diuretic therapy with human serum albumin to the management of ascites in patients with advanced liver cirrhosis: A prospective cohort study.

作者信息

Nakamura Toru, Sata Michio, Hiroishi Kazumasa, Masaki Naohiko, Moriwaki Hisataka, Murawaki Yoshikazu, Yatsuhashi Hiroshi, Fujiyama Shigetoshi, Imawari Michio

机构信息

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011; ; Liver Cancer Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka 830-0011;

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011;

出版信息

Mol Clin Oncol. 2014 May;2(3):349-355. doi: 10.3892/mco.2014.245. Epub 2014 Jan 16.

Abstract

The number of available studies on the role of human serum albumin (HSA) in the treatment of cirrhotic ascites is currently limited. In this study, we aimed to investigated the parameters associated with diuretic therapy with HSA in patients with advanced cirrhotic ascites. The patient inclusion criteria were cirrhotic ascites and a serum albumin (Alb) concentration of <3.5 g/dl. A total of 49 patients registered and 38 patients were ultimately included in this study. The enrolled patients were mainly treated with oral spironolactone and furosemide, which were not specified; the HSA amount was also not specified, although the administration period was set to a maximum of 7 days. Our results demonstrated that the administration of HSA significantly increased the serum levels of Alb [0.97 g/dl; two-sided 95% confidence interval (CI): 0.83-1.11 g/dl] and decreased body weight (-2.24 kg; 95% CI: -3.06 to -1.43 kg), hematocrit ratio (0.96; 95% CI: 0.94-0.98) and plasma renin concentration (day 4; geometric mean fold change, -0.1528; 95% CI: -0.2510 to -0.0545; log-transformed data) in patients with advanced cirrhotic ascites. The observed weight loss was found to be correlated with the total amount of HSA administered (P=0.0012), as indicated by the results of the multiple linear regression analysis. In conclusion, this study confirmed the efficacy of HSA in patients with advanced cirrhotic ascites.

摘要

目前,关于人血清白蛋白(HSA)在肝硬化腹水治疗中作用的现有研究数量有限。在本研究中,我们旨在调查晚期肝硬化腹水患者使用HSA进行利尿治疗相关的参数。患者纳入标准为肝硬化腹水且血清白蛋白(Alb)浓度<3.5 g/dl。共有49例患者登记,最终38例患者纳入本研究。纳入的患者主要接受未明确说明的口服螺内酯和呋塞米治疗;HSA用量也未明确说明,尽管给药期设定最长为7天。我们的结果表明,在晚期肝硬化腹水患者中,给予HSA可显著提高血清Alb水平[0.97 g/dl;双侧95%置信区间(CI):0.83 - 1.11 g/dl],并降低体重(-2.24 kg;95% CI:-3.06至-1.43 kg)、血细胞比容(0.96;95% CI:0.94 - 0.98)和血浆肾素浓度(第4天;几何平均变化倍数,-0.1528;95% CI:-0.2510至-0.0545;对数转换数据)。多元线性回归分析结果表明,观察到的体重减轻与给予的HSA总量相关(P = 0.0012)。总之,本研究证实了HSA在晚期肝硬化腹水患者中的疗效。

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