人血白蛋白在肝硬化及其并发症中的应用  

The application of human serum albumin in liver cirrhosis and its complications

作　　者：李雅欣 丁惠国 LI Yaxin;DING Huiguo(Department of Hepatology and Gastroenterology,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院肝病消化中心,北京100069

出　　处：《临床肝胆病杂志》2025年第3期409-414,共6页Journal of Clinical Hepatology

基　　金：首都卫生发展科研专项(2022-1-2181)。

摘　　要：白蛋白由肝脏生物合成,当肝脏严重损伤时,白蛋白不仅合成减少,其结构亦发生变化(如甲基化、糖基化等增多),导致循环中有效白蛋白浓度显著降低。白蛋白不仅能维持血浆胶体渗透压,还具备抗氧化、抗炎、免疫调节和物质运输等非胶体功能。目前,指南推荐人血白蛋白短期用于肝硬化患者大量放腹水、肝肾综合征和自发性细菌性腹膜炎的治疗,可降低病死率;人血白蛋白在肝硬化低钠血症、非自发性细菌性腹膜炎感染和肝性脑病中可能改善预后。但是,人血白蛋白在肝硬化及相关并发症中应用的剂量及长期应用的效果仍存在争议。Albumin is synthesized in the liver,and in case of severe liver injury,albumin synthesis is reduced with structural alterations(such as an increase in methylation and glycosylation),leading to a significant reduction in effective albumin in circulation.Albumin not only maintains plasma oncotic pressure,but also has the functions of antioxidation,anti-inflammation,immunomodulation,and transport.Current guidelines recommend the short-term application of human serum albumin in the treatment of large-volume paracentesis,hepatorenal syndrome,and spontaneous bacterial peritonitis in patients with liver cirrhosis,as it is shown that human serum albumin can help to reduce mortality.In addition,human serum albumin may improve the prognosis of cirrhotic patients with hyponatremia,non-SBP infections,and hepatic encephalopathy.However,there are still controversies over the application of human serum albumin in liver cirrhosis and related complications in terms of optimal dose and long-term efficacy.

关 键 词：白蛋白类 肝硬化 腹水 肝肾综合征 肝性脑病 治疗学 

分 类 号：R57[医药卫生—消化系统]