Bai Zhaohui, Bernardi Mauro, Yoshida Eric M, Li Hongyu, Guo Xiaozhong, Méndez-Sánchez Nahum, Li Yingying, Wang Ran, Deng Jiao, Qi Xingshun
Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, P.R. China.
Postgraduate College, Shenyang Pharmaceutical University, Shenyang, P.R. China.
Aging (Albany NY). 2019 Oct 8;11(19):8502-8525. doi: 10.18632/aging.102335.
The role of human albumin infusion for the prevention and treatment of overt hepatic encephalopathy (HE) in liver cirrhosis remains unclear.
Among the 708 patients without pre-existing overt HE, albumin infusion significantly decreased the incidence of overt HE (4.20% versus 12.70%, P<0.001) and in-hospital mortality (1.70% versus 5.40%, P=0.008). Among the 182 patients with overt HE at admission or during hospitalization, albumin infusion significantly improved overt HE (84.60% versus 68.10%, P=0.009) and decreased in-hospital mortality (7.70% versus 19.80%, P=0.018). Meta-analysis of 6 studies found that albumin infusion might decrease the risk of overt HE (OR=1.63, P=0.07), but the difference was not statistically significant. Meta-analysis of 3 studies found that albumin infusion significantly improved overt HE (OR=2.40, P=0.04).
Based on the results of our retrospective study and meta-analysis, albumin infusion might prevent from the occurrence of overt HE and improve the severity of overt HE in cirrhosis. Our retrospective study also suggested that albumin infusion improved the outcomes of cirrhotic patients regardless of overt HE.
Cirrhotic patients consecutively admitted between January 2010 and June 2014 were considered in a retrospective study. A 1:1 propensity score matching analysis was performed. Additionally, publications regarding albumin infusion for the management of overt HE were systematically searched. Meta-analyses were performed by random-effect model. Odds ratio (OR) was calculated.
人血白蛋白输注在肝硬化显性肝性脑病（HE）预防和治疗中的作用仍不明确。
在708例无既往显性HE的患者中，白蛋白输注显著降低了显性HE的发生率（4.20%对12.70%，P<0.001）和住院死亡率（1.70%对5.40%，P=0.008）。在182例入院时或住院期间患有显性HE的患者中，白蛋白输注显著改善了显性HE（84.60%对68.10%，P=0.009）并降低了住院死亡率（7.70%对19.80%，P=0.018）。对6项研究的荟萃分析发现，白蛋白输注可能降低显性HE的风险（OR=1.63，P=0.07），但差异无统计学意义。对3项研究的荟萃分析发现，白蛋白输注显著改善了显性HE（OR=2.40，P=0.04）。
基于我们的回顾性研究和荟萃分析结果，白蛋白输注可能预防肝硬化患者发生显性HE并改善显性HE的严重程度。我们的回顾性研究还表明，无论是否存在显性HE，白蛋白输注均可改善肝硬化患者的预后。
对2010年1月至2014年6月连续入院的肝硬化患者进行回顾性研究。进行1:1倾向评分匹配分析。此外，系统检索了关于白蛋白输注治疗显性HE的文献。采用随机效应模型进行荟萃分析。计算比值比（OR）。
