Aparato Digestivo, Hospital Universitario de Navarra.
Aparato Digestivo, Hospital Universitario Fundación Alcorcón.
Rev Esp Enferm Dig. 2023 Aug;115(8):414-417. doi: 10.17235/reed.2022.9216/2022.
Ascites is the most frequent complication of cirrhosis and carries with it a high morbidity and mortality. The results of the ANSWER study and others like it open the possibility of considering the prolonged administration of albumin, as an effective and safe treatment in patients with decompensated cirrhosis, capable of modifying their natural history, allowing a better control of ascites, a lower incidence of other complications of portal hypertension, and an increased survival. For this, it is necessary the administration of albumin with the appropriate dose and duration to restore their physiological conditions. However, new studies are needed to confirm the efficacy and safety of prolonged administration of albumin in patients with decompensated cirrhosis and to identify the subpopulation of patients that benefit the most, the appropriate dose and duration, serum-clinical markers of response, the necessary logistics to facilitate its application and its cost-effectiveness in the different health systems.
腹水是肝硬化最常见的并发症，伴有高发病率和死亡率。ANSWER 研究及其类似研究的结果为我们提供了一种可能性，即考虑长期给予白蛋白治疗失代偿期肝硬化患者，这种方法有效且安全，能够改变其自然病程，更好地控制腹水，降低门脉高压其他并发症的发生率，并提高生存率。为此，有必要给予适当剂量和持续时间的白蛋白治疗，以恢复其生理状态。然而，还需要新的研究来证实长期给予白蛋白治疗失代偿期肝硬化患者的疗效和安全性，并确定获益最大的患者亚群、适当的剂量和持续时间、对治疗有反应的血清临床标志物、为方便应用白蛋白所需的后勤保障以及其在不同卫生系统中的成本效益。
