NEJM: In 70 years of ups and downs, the status of albumin infusion in the treatment of liver cirrhosis will be rewritten!

Liver cirrhosis is diffuse damage to the liver caused by long-term and repeated stimulation of one or more causes.

Early liver function can still be compensated, and cirrhosis develops to a certain extent, which exceeds the compensatory capacity of liver function, which is called decompensated period of liver cirrhosis.

Both hepatitis B and hepatitis C can be regarded as a major hepatitis country in China, and hepatitis B has always been an important cause of liver cirrhosis.

The main clinical manifestations of patients with decompensated liver cirrhosis are symptoms and signs caused by liver function decline and portal hypertension.

Immune albumin level has always been an important indicator reflecting immune function and nutritional level.

In hospitalized patients with liver cirrhosis, low albumin levels are associated with an increased risk of death.

To this end, scholars from the University of London in the United Kingdom led an international large-scale trial called ATTIRE to comprehensively evaluate whether daily infusion of large amounts of albumin can bring more to hospitalized patients with advanced liver cirrhosis than "standard treatment" Significant benefits.

The study is a randomized, multi-center, open-label, parallel group trial, involving hospitalized patients with decompensated cirrhosis with serum albumin levels below 30 g/L at the time of entry.

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Results A total of 777 patients were included, among which alcohol is one of the causes of liver cirrhosis.

Overall, the proportion of patients with primary endpoint events between the targeted albumin group (113 of 380 patients [29.

There was no significant difference in the proportion of patients with primary endpoint events between the targeted albumin group (113 of 380 patients [29.

For this reason, the researchers pointed out that compared with high-dose albumin infusion, we should pay more attention to the prevention of chronic liver disease , especially the prevention of chronic liver cirrhosis caused by alcohol consumption and obesity.

Compared with high-dose albumin infusion, we should pay more attention to the prevention of chronic liver disease , especially the prevention of chronic liver cirrhosis caused by drinking and obesity.

For patients hospitalized with decompensated liver cirrhosis, infusion of albumin to increase the albumin level to the goal of ≥30g/L is not more beneficial than the current standard care.

references:

A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis.

A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis.
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