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白蛋白在肝硬化中的作用:从一名住院医师的视角

Role of albumin in cirrhosis: from a hospitalist's perspective.

作者信息

Walayat Saqib, Martin Daniel, Patel Jaymon, Ahmed Umair, N Asghar Muhammad, Pai Aparna U, Dhillon Sonu

机构信息

Department of Internal Medicine, University of Illinois Peoria Campus, OSF Saint Francis Medical Center, Peoria, IL, USA.

Department of Gastroenterology and Hepatology, University of Illinois Peoria Campus, OSF Saint Francis Medical Center, Peoria, IL, USA.

出版信息

J Community Hosp Intern Med Perspect. 2017 Mar 31;7(1):8-14. doi: 10.1080/20009666.2017.1302704. eCollection 2017 Jan.

DOI:10.1080/20009666.2017.1302704
PMID:28634518
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5463675/
Abstract

Albumin, a negatively charged globular protein encoded on chromosome 4, is one of the most abundant proteins in the plasma and accounts for approximately 75% of plasma oncotic pressure. The role of albumin in the management of various disease states has shown to be beneficial historically. Low serum albumin is a predictor of mortality and poor outcomes. In cirrhotics undergoing paracentesis, albumin infusion prevents rapid re-accumulation of ascitic fluid while simultaneously decreasing the risk of post-paracentesis related circulatory dysfunction. Additionally, albumin is utilized in patients with hepatorenal syndrome (HRS) and spontaneous bacterial peritonitis (SBP). Overall, albumin appears to be an effective pharmacological agent in the management of cirrhosis and its complications.

摘要

白蛋白是一种由4号染色体编码的带负电荷的球状蛋白,是血浆中含量最丰富的蛋白质之一,约占血浆胶体渗透压的75%。从历史上看,白蛋白在各种疾病状态的管理中所起的作用已被证明是有益的。低血清白蛋白是死亡率和不良预后的一个预测指标。在接受腹腔穿刺术的肝硬化患者中,输注白蛋白可防止腹水迅速重新积聚,同时降低腹腔穿刺术后相关循环功能障碍的风险。此外,白蛋白还用于肝肾综合征(HRS)和自发性细菌性腹膜炎(SBP)患者。总体而言,白蛋白似乎是治疗肝硬化及其并发症的一种有效药物。

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本文引用的文献

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Effects of intravenous albumin in patients with cirrhosis and episodic hepatic encephalopathy: a randomized double-blind study.肝硬化伴间歇性肝性脑病患者静脉注射白蛋白的效果:一项随机、双盲研究。
J Hepatol. 2013 Dec;59(6):1184-92. doi: 10.1016/j.jhep.2013.07.020. Epub 2013 Jul 19.
2
Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012.2012年美国肝病研究协会肝硬化所致成人腹水患者管理实践指南修订版介绍。
Hepatology. 2013 Apr;57(4):1651-3. doi: 10.1002/hep.26359.
3
Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial.应用分子吸附再循环系统的体外白蛋白透析治疗慢加急性肝衰竭:RELIEF 试验。
Hepatology. 2013 Mar;57(3):1153-62. doi: 10.1002/hep.26185. Epub 2013 Feb 15.
4
Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials.白蛋白输注改善自发性细菌性腹膜炎患者的结局:一项随机试验的荟萃分析。
Clin Gastroenterol Hepatol. 2013 Feb;11(2):123-30.e1. doi: 10.1016/j.cgh.2012.11.007. Epub 2012 Nov 22.
5
Positive cardiac inotropic effect of albumin infusion in rodents with cirrhosis and ascites: molecular mechanisms.白蛋白输注对肝硬化腹水啮齿动物的正性心肌变力作用:分子机制。
Hepatology. 2013 Jan;57(1):266-76. doi: 10.1002/hep.26021.
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The combination of octreotide and midodrine is not superior to albumin in preventing recurrence of ascites after large-volume paracentesis.奥曲肽和米多君联合治疗并不优于白蛋白预防大量腹腔穿刺放液后腹水复发。
Clin Gastroenterol Hepatol. 2012 Oct;10(10):1169-75. doi: 10.1016/j.cgh.2012.06.027. Epub 2012 Jul 16.
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Hyponatremia in cirrhosis and end-stage liver disease: treatment with the vasopressin V₂-receptor antagonist tolvaptan.肝硬化和终末期肝病中的低钠血症:用血管加压素 V₂-受体拮抗剂托伐普坦治疗。
Dig Dis Sci. 2012 Nov;57(11):2774-85. doi: 10.1007/s10620-012-2276-3. Epub 2012 Jun 26.
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Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study.肝硬化自发性细菌性腹膜炎以外的细菌感染用白蛋白。一项随机对照研究。
J Hepatol. 2012 Oct;57(4):759-65. doi: 10.1016/j.jhep.2012.06.013. Epub 2012 Jun 23.
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Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials.大量腹腔穿刺术患者输注白蛋白:随机试验的荟萃分析。
Hepatology. 2012 Apr;55(4):1172-81. doi: 10.1002/hep.24786.
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How albumin administration for cirrhosis impacts on hospital albumin consumption and expenditure.肝硬化患者白蛋白给药对医院白蛋白消耗和支出的影响。
World J Gastroenterol. 2011 Aug 14;17(30):3479-86. doi: 10.3748/wjg.v17.i30.3479.