人血白蛋白制剂在肿瘤营养治疗作用中的商榷  

Discussion on the role of albumin preparations in tumor nutritional therapy

作　　者：吕大鹏 穆颖 曹冰清 Lyu Dapeng;Mu Ying;Cao Bingqing(Breast Center,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Surgery Department,Peking University Hospital,Beijing 100871,China;Respiratory Department,Capital Institute Pediatrics,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京世纪坛医院乳腺中心,北京100038 [2]北京大学医院外科,北京100871 [3]首都医科大学附属北京儿科研究所呼吸内科,北京100020

出　　处：《肿瘤代谢与营养电子杂志》2024年第4期480-484,共5页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：恶性肿瘤患者常因慢性能量-蛋白质消耗及机体的其他营养素的摄入不足、吸收障碍,导致以蛋白质和能量不足为主的营养不良。白蛋白水平能够反映患者营养状况。临床上,常常误把人血白蛋白制剂作为营养物质使用。实际上,对于肿瘤患者的营养供给应该以氨基酸和能量补充为主。本文分析了人体营养需求的基本要点,肿瘤患者的代谢改变、营养状况分类和营养供给要点、原则和方法;人体营养素的分类和供给剂量的具体计算方法;临床上可以提供的各种氨基酸制剂类型。详细分析了白蛋白在体内的合成和分布。白蛋白在人体内主要作用是在扩充血容量的同时,维持血浆的正常渗透压,同时还具有非渗透压的生物学功能。回顾了人血白蛋白制剂的应用历史,国内外使用人血白蛋白制剂的临床使用指南。人血白蛋白制剂在各种疾病中应用的意义,主要应用于由于烧伤或创伤等引起的重度休克、严重肝硬化或重度肾病引起的重度腹水和严重水肿、脑血管疾病引起的脑水肿、新生儿高胆红素血症等。分析了人血白蛋白制剂在临床应用中的几个误区。本文为如何正确为肿瘤患者提供营养、如何正确合理使用人血白蛋白制剂提供理论依据。Patients with malignant tumors often suffer from malnutrition due to chronic energy-protein depletion,insufficient intake of other nutrients in the body,and malabsorption,resulting in energy and protein deficiency.Serum albumin level is an important indicator to reflect the nutritional status of patients.Clinically,albumin preparations are often mistakenly used as nutrients in clinical practice.In fact,the nutritional supply of cancer patients should be based on amino acids and energy supplementation.This article analyzes the basic points of human nutritional requirements,metabolic changes,nutritional status classification and nutrient supply of cancer patients.And we discussed the principles,methods and classification of human nutrients and specific calculation methods of dosage supply;A variety of amino acid formulation types that can be provided clinically.The synthesis and distribution of albumin in vivo were analyzed in detail.The main role of serum albumin in the human body is to expand blood volume and maintain plasma osmolality,and it also has the biological function of non-osmotic pressure.The application history of albumin preparations and the clinical guidelines for albumin preparations in China and abroad are reviewed.The significance of albumin preparations in the application of various diseases is mainly used in shock caused by trauma and burns,edema and ascites caused by liver cirrhosis or kidney disease,cerebral edema,neonatal hyperbilirubinemia.The misunderstandings of the clinical application of human albumin preparations were analyzed.This article provides a theoretical basis for how to correctly provide nutrition for cancer patients and how to use albumin preparations correctly and rationally.

关 键 词：人血白蛋白制剂 肿瘤 营养 氨基酸 能量 水肿 低蛋白血症 免疫功能 

分 类 号：R730.5[医药卫生—肿瘤]