Bai Zhaohui, Xu Wentao, Chai Lu, Zheng Xiaojie, Méndez-Sánchez Nahum, Philips Cyriac Abby, Cheng Gang, Qi Xingshun
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, China.
NMPA Key Laboratory for Research and Evaluation of Drug Regulatory Technology, Shenyang Pharmaceutical University, Shenyang 110016, China.
J Clin Med. 2022 Dec 23;12(1):107. doi: 10.3390/jcm12010107.
Background: Human albumin (HA) infusion is potentially effective for the management of hyponatremia in liver cirrhosis, but the current evidence is very limited. Methods: In this retrospective study, 2414 cirrhotic patients who were consecutively admitted to our hospital between January 2010 and June 2014 were included in the Hospitalization outcome cohort, and 339 cirrhotic patients without malignancy who were consecutively admitted to our department between December 2014 and April 2021 were included in the Long-term outcome cohort. The development and improvement of hyponatremia were compared between patients who received HA infusion during hospitalizations and did not. Logistic and Cox regression analyses were performed to evaluate the association of development and improvement of hyponatremia during hospitalizations with the outcomes. Odds ratios (ORs) and hazard ratios (HRs) were calculated. Results: In the two cohorts, HA infusion significantly decreased the incidence of hyponatremia and increased the rate of improvement of hyponatremia in cirrhotic patients during hospitalizations. In the Hospitalization outcome cohort, the development of hyponatremia during hospitalizations was significantly associated with increased in-hospital mortality (OR = 2.493, p < 0.001), and the improvement of hyponatremia during hospitalizations was significantly associated with decreased in-hospital mortality (OR = 0.599, p = 0.014). In the Long-term outcome cohort, the development of hyponatremia during hospitalizations was significantly associated with decreased long-term survival (HR = 0.400, p < 0.001), and the improvement of hyponatremia during hospitalizations was not significantly associated with long-term survival (HR = 1.085, p = 0.813). Conclusions: HA infusion can effectively prevent the development of hyponatremia and improve hyponatremia in cirrhotic patients during hospitalizations, which may influence the patients’ outcomes.
输注人血白蛋白(HA)可能对肝硬化低钠血症的治疗有效,但目前证据非常有限。方法:在这项回顾性研究中,2010年1月至2014年6月期间连续入住我院的2414例肝硬化患者被纳入住院结局队列,2014年12月至2021年4月期间连续入住我科的339例无恶性肿瘤的肝硬化患者被纳入长期结局队列。比较住院期间接受HA输注和未接受HA输注的患者低钠血症的发生及改善情况。进行逻辑回归和Cox回归分析,以评估住院期间低钠血症的发生及改善与结局之间的关联。计算比值比(OR)和风险比(HR)。结果:在两个队列中,HA输注显著降低了肝硬化患者住院期间低钠血症的发生率,并提高了低钠血症的改善率。在住院结局队列中,住院期间低钠血症的发生与住院死亡率增加显著相关(OR = 2.493,p < 0.001),住院期间低钠血症的改善与住院死亡率降低显著相关(OR = 0.599,p = 0.014)。在长期结局队列中,住院期间低钠血症的发生与长期生存率降低显著相关(HR = 0.400,p < 0.001),住院期间低钠血症的改善与长期生存率无显著相关(HR = 1.085,p = 0.813)。结论:HA输注可有效预防肝硬化患者住院期间低钠血症的发生并改善低钠血症,这可能影响患者的结局。