人血白蛋白在危重症患者中临床应用的评价

周婷; 杨珍; 陆赛花; 刘秀凤; 张晔; 徐峰

doi:10.3969/j.issn.1006-0111.2017.02.018

人血白蛋白在危重症患者中临床应用的评价

doi: 10.3969/j.issn.1006-0111.2017.02.018

周婷¹,
杨珍²,
陆赛花¹,
刘秀凤¹,
张晔¹,
徐峰^1,

1.
上海交通大学附属第六人民医院南院药剂科, 上海 201499
2.
锦州医科大学附属奉贤医院药剂科, 上海 201499

基金项目: 上海市卫生计生委青年项目（20134y171）；上海市医院药学科研基金（2013-YY-01-04）

Evaluation on the clinical utilization of human serum albumin in ICU patients

1.
Department of Pharmacy, South Campus, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201499, China
2.
Department of Pharmacy, Fengxian Hospital, Jinzhou Medical University, Shanghai 201499, China

摘要: 目的评价重症监护病房（ICU）人血白蛋白（human serum albumin， HSA）合理使用情况，促进HSA的合理应用。方法收集2015年1月1日至2015年12月31日ICU使用HSA患者信息，对HSA使用情况进行统计分析，评价使用的合理性。结果 64例患者使用HSA共计416支，平均用量62.5 g；使用HSA主要原因为低蛋白血症（39.1%），其次为脑水肿、颅脑外伤、各型休克及恶性肿瘤等。使用HSA前，患者血清白蛋白水平在25~35 g/L的占35.9%，15~25 g/L的占56.3%。结论 ICU的HSA使用广泛，涉及多种用途，但存在超适应证使用等不合理使用情况。呼吁相关部门尽快出台HSA使用指南，促使各医疗机构规范使用。
- 人血白蛋白 /
- 合理应用 /
- 评价 /
- 危重症患者
Abstract: Objective To evaluate the utilization of human serum albumin (HSA) in intensive care unit (ICU) to promote rational use of HSA clinically. Methods Data were collected from the patients received HSA therapy during the period of January 1, 2015 to December 31, 2015. The indications and usage of HSA were analyzed statistically. Results 416 bottles of HSA were administered to 64 patients. The average dose was 62.5g per patient. The most popular indication was for hypoproteinemia (39.1%) followed by encephaledema, craniocerebral trauma, shock and tumors. Before the HSA therapy, 36 patients (56.3%) had albumin level of 15-25 g/L and 23 patients (35.9%) of 25-35 g/L. Conclusion HSA is widely used in ICU for different indications. Some misuses still exist. Guidelines for proper use of HSA are needed to guarantee its rational use. HSA should be used strictly following these guidelines.
- human serum albumin (HSA) /
- rational use /
- evaluate /
- intensive care patients

[1]	Fanali G, di Masi A, Trezza V,et al. Human serum albumin:from bench to bedside[J]. Mol Aspects Med,2012,33(3):209-290.
[2]	Mendez CM, McClain CJ, Marsano LS. Albumin therapy in clinical practice[J]. Nutr Clin Pract,2005,20(3):314-320.
[3]	Liberati A, Moja L, Moschetti I, et al. Human albumin solution for resuscitation and volume expansion in critically ill patients[J]. Intern Emerg Med,2006,1(3):243-245.
[4]	Vincent JL. Resuscitation using albumin in critically ill patients:research in patients at high risk of complications is now needed[J]. BMJ,2006,333(7577):1029-1030.
[5]	Zhou T, Lu SH, Liu XF, et al., Review of the rational use and adverse reactions to human serum albumin in the People's Republic of China[J].Patient Prefer Adherence,2013,7:1207-1212.
[6]	Vincent JL, Wilkes MM, Navickis RJ. Safety of human albumin-serious adverse events reported worldwide in 1998-2000[J]. Br J Anaesth,2003,91(5):625-630.
[7]	Sikuler E, Shapira A, Mor-Yosef S, et al. Rational use of albumin[J]. Harefuah, 2000, 139(5-6):190-193, 246.
[8]	Vermeulen LC Jr, Ratko TA, Erstad BL, et al. A paradigm for consensus. The University Hospital Consortium guidelines for the use of albumin, nonprotein colloid, and crystalloid solutions[J]. Arch Intern Med,1995,155(4):373-379.
[9]	Suarez JI, Martin RH, Calvillo E, et al. The albumin in subarachnoid hemorrhage (ALISAH)multicenter pilot clinical trial:safety and neurologic outcomes[J]. Stroke,2012,43(3):683-690.
[10]	赵龙姝,雷鸣,时扣荣,等. 不同浓度人血白蛋白对老年脑出血危重患者的疗效研究[J]. 临床急诊杂志, 2015,16(5):373-375.
[11]	Perel P, Roberts I. Colloids versus crystalloids for fluid resuscitation in critically ill patients[J]. Cochrane Database Syst Rev,2011(3):CD000567.
[12]	Caironi P, Langer T, Gattinoni L.Albumin in critically ill patients:the ideal colloid[J]. Curr Opin Crit Care,2015,21(4):302-308.
[13]	Takahashi I, Ohnuma T, Kavy S, et al. Interaction of human serum albumin with anticancer agents in vitro[J]. Br J Cancer,1980,41(4):602-608.
[14]	Gou Y,Yang F,Liang H. Designing prodrugs based on special residues of human serum albumin[J]. Curr Top Med Chem,2016,16(9):996-1008.
[15]	王丹,陈慧,刘丽宏,等. 172例人血清蛋白临床应用合理性调查与分析[J]. 药学实践杂志,2014,32(3):231-234.
[16]	Ting YX, Wang B. Investigation and analysis of human serum albumin clinical utilization[J]. Chin pharm J,2010,45(13):1035-1038.
[17]	Roberts I, Blackhall K, Alderson P, et al. Human albumin solution for resuscitation and volume expansion in critically ill patients[J]. Cochrane Database Syst Rev, 2011, (11):CD001208.
[18]	Saw MM, Chandler B, Ho KM. Benefits and risks of using gelatin solution as a plasma expander for perioperative and critically ill patients:a meta-analysis[J]. Anaesth Intensive Care,2012,40(1):17-32.
[19]	Pulimood TB,Park GR. Debate:Albumin administration should be avoided in the critically ill[J]. Crit Care,2000,4(3):151-155.
[20]	Finfer S,Bellomo R, Boyce N, et a1.A comparison of albumin and saline for fluid resuscitation in the intensive care unit[J]. N Engl J Med,2004,350(22):2247-2256.

[1]	毛智毅, 王筱燕, 陈晓颖, 汤逸斐. 度拉糖肽联合二甲双胍对肥胖型2型糖尿病患者机体代谢、体脂成分及血清脂肪因子的影响 . 药学实践与服务, 2024, 42(7): 305-309. doi: 10.12206/j.issn.2097-2024.202305032
[2]	石晓萍, 吕迁洲, 李晓宇, 许青. 泊沙康唑对比伏立康唑经验治疗或诊断驱动治疗免疫功能低下患者侵袭性霉菌病的成本-效果分析 . 药学实践与服务, 2024, 42(): 1-8. doi: 10.12206/j.issn.2097-2024.202401050
[3]	史生辉, 石飞, 雷琼, 王亚峰, 吴雪花. 青藏高原肺结核合并念珠菌感染患者的病原菌分布特点及耐药率分析 . 药学实践与服务, 2024, 42(6): 260-262, 272. doi: 10.12206/j.issn.2097-2024.202304014
[4]	陈春娟, 郑志新, 李骊. 平喘方联合孟鲁司特钠治疗儿童支气管哮喘患者的临床疗效观察 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202405035
[5]	张广雨, 杜晶, 刘梦珍, 朱丹妮, 闫慧, 刘冲. 新斯的明与山莨菪碱联合应用对肺型氧中毒的保护作用及其机制的研究 . 药学实践与服务, 2024, 42(10): 433-438, 444. doi: 10.12206/j.issn.2097-2024.202310049
[6]	王晓飞, 张颖, 顾佳钰, 胡馨儿, 张海, 曹岩. 表面等离子共振传感器的识别元件在医药领域中的研究应用进展 . 药学实践与服务, 2024, 42(): 1-9. doi: 10.12206/j.issn.2097-2024.202309014
[7]	杨凤艳, 张月, 陈恩贤, 缪雪蓉, 魏凯. 瑞马唑仑临床应用研究进展 . 药学实践与服务, 2024, 42(9): 365-374. doi: 10.12206/j.issn.2097-2024.202405026
[8]	杨彬, 王作君, 陈菡, 张敬一. 基于DRGs的医院合理用药管理机制探索实践 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202404030
[9]	陈怡君, 王卓, 何苗, 张宇, 田泾. 泌尿系统碎石术抗菌药物预防使用合理管控实践 . 药学实践与服务, 2024, 42(): 1-5. doi: 10.12206/j.issn.2097-2024.202402034
[10]	刘汝雄, 杨万镇, 涂杰, 盛春泉. 铁死亡调控蛋白GPX4的小分子抑制剂研究进展 . 药学实践与服务, 2024, 42(9): 375-378. doi: 10.12206/j.issn.2097-2024.202312075
[11]	杨嘉宁, 赵一颖, 肖伟. 七味脂肝方对非酒精性脂肪性肝炎动物模型的药效学评价 . 药学实践与服务, 2024, 42(9): 389-398. doi: 10.12206/j.issn.2097-2024.202404096
[12]	宋雨桐, 夏德润, 顾珩, 唐少文, 易洪刚, 沃红梅. 帕博利珠单抗与铂类化疗方案在晚期非小细胞肺癌一线治疗中的药物经济学评价 . 药学实践与服务, 2024, 42(8): 334-340. doi: 10.12206/j.issn.2097-2024.202303023
[13]	王鹏, 陈顺, 赵逸, 高守红, 王志鹏. 卡培他滨致小鼠手足综合征模型的建立及评价 . 药学实践与服务, 2024, 42(9): 385-388, 398. doi: 10.12206/j.issn.2097-2024.202308045
[14]	景凯, 杨慈荣, 张圳, 臧艺蓓, 刘霞. 黄芪甲苷衍生物治疗慢性心力衰竭小鼠的药效评价及作用机制研究 . 药学实践与服务, 2024, 42(5): 190-197. doi: 10.12206/j.issn.2097-2024.202310004
[15]	刘依秦, 王超群, 邱娇娜. 胆宁片预处理在糖尿病患者结肠镜检查前的应用效果分析 . 药学实践与服务, 2024, 42(9): 407-410. doi: 10.12206/j.issn.2097-2024.202407037
[16]	丁千雪, 尚圣兰, 余梦辰, 余爱荣. 机器学习在肾病综合征患者他克莫司个体化用药中的应用 . 药学实践与服务, 2024, 42(6): 227-230, 243. doi: 10.12206/j.issn.2097-2024.202310007
[17]	练鲁英, 刘盈, 殷佳, 诸国樑, 徐飞. 上海某三级公立医院药品管理内部控制评价实践研究 . 药学实践与服务, 2024, 42(): 1-7. doi: 10.12206/j.issn.2097-2024.202402003
[18]	张晶晶, 索丽娜, 郑兆红. 89例细菌性肝脓肿的临床特征及抗感染治疗分析 . 药学实践与服务, 2024, 42(6): 267-272. doi: 10.12206/j.issn.2097-2024.202302039

点击查看大图

计量

文章访问数: 3253
HTML全文浏览量: 553
PDF下载量: 460
被引次数: 0

姓名
邮箱
手机号码
标题
留言内容
验证码

留言板

人血白蛋白在危重症患者中临床应用的评价

doi: 10.3969/j.issn.1006-0111.2017.02.018

Evaluation on the clinical utilization of human serum albumin in ICU patients

计量

人血白蛋白在危重症患者中临床应用的评价

doi: 10.3969/j.issn.1006-0111.2017.02.018

1. 上海交通大学附属第六人民医院南院药剂科, 上海 201499

2. 锦州医科大学附属奉贤医院药剂科, 上海 201499

English Abstract

Evaluation on the clinical utilization of human serum albumin in ICU patients

1. Department of Pharmacy, South Campus, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201499, China

2. Department of Pharmacy, Fengxian Hospital, Jinzhou Medical University, Shanghai 201499, China

全文HTML

目录

留言板

人血白蛋白在危重症患者中临床应用的评价

doi: 10.3969/j.issn.1006-0111.2017.02.018

Evaluation on the clinical utilization of human serum albumin in ICU patients

计量

出版历程

人血白蛋白在危重症患者中临床应用的评价

doi: 10.3969/j.issn.1006-0111.2017.02.018

1. 上海交通大学附属第六人民医院南院药剂科, 上海 201499 2. 锦州医科大学附属奉贤医院药剂科, 上海 201499

English Abstract

Evaluation on the clinical utilization of human serum albumin in ICU patients

1. Department of Pharmacy, South Campus, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201499, China 2. Department of Pharmacy, Fengxian Hospital, Jinzhou Medical University, Shanghai 201499, China

全文HTML

目录

1. 上海交通大学附属第六人民医院南院药剂科, 上海 201499

2. 锦州医科大学附属奉贤医院药剂科, 上海 201499

1. Department of Pharmacy, South Campus, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201499, China

2. Department of Pharmacy, Fengxian Hospital, Jinzhou Medical University, Shanghai 201499, China