Abstract：
BACKGROUND: Human albumin infusion is effective for controlling systemic inflammation, thereby probably managing some liver cirrhosis-related complications, such as spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and hepatorenal syndrome. However, its clinical benefits remain controversial.
METHODS: EMBASE, PubMed, and Cochrane Library databases were searched. Randomized controlled trials (RCTs) regarding use of human albumin infusion in cirrhotic patients were eligible. Mortality and incidence of liver cirrhosis-related complications were pooled. Effect of human albumin infusion on mortality was also evaluated by subgroup analyses primarily according to target population and duration of human albumin infusion treatment. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
RESULTS: Forty-two RCTs were finally included. Meta-analysis showed that human albumin infusion could significantly decrease the mortality of cirrhotic patients (OR = 0.81, 95% CI = 0.67-0.98, p = 0.03). Subgroup analyses showed that human albumin infusion could significantly decrease the mortality of cirrhotic patients with SBP (OR = 0.36, 95% CI = 0.20-0.64, p = 0.0005) and HE (OR = 0.43, 95% CI = 0.22-0.85, p = 0.02), but not those with ascites or non-SBP infections or undergoing large-volume paracentesis. Short-term human albumin infusion treatment could significantly decrease short-term mortality (OR = 0.67, 95% CI = 0.50-0.89, p = 0.005), but not long-term mortality. Long-term human albumin infusion treatment could not significantly decrease long-term mortality (OR = 0.72, 95% CI = 0.48-1.08, p = 0.11). In addition, human albumin infusion could significantly decrease the incidence of renal impairment (OR = 0.63, 95% CI = 0.45-0.88, p = 0.007) and ascites (OR = 0.45, 95% CI = 0.25-0.81, p = 0.007), but not infections or gastrointestinal bleeding.
CONCLUSIONS: Human albumin infusion may improve the outcomes of cirrhotic patients. However, its indications for different complications and infusion strategy in liver cirrhosis should be further explored.
METHODS: EMBASE, PubMed, and Cochrane Library databases were searched. Randomized controlled trials (RCTs) regarding use of human albumin infusion in cirrhotic patients were eligible. Mortality and incidence of liver cirrhosis-related complications were pooled. Effect of human albumin infusion on mortality was also evaluated by subgroup analyses primarily according to target population and duration of human albumin infusion treatment. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
RESULTS: Forty-two RCTs were finally included. Meta-analysis showed that human albumin infusion could significantly decrease the mortality of cirrhotic patients (OR = 0.81, 95% CI = 0.67-0.98, p = 0.03). Subgroup analyses showed that human albumin infusion could significantly decrease the mortality of cirrhotic patients with SBP (OR = 0.36, 95% CI = 0.20-0.64, p = 0.0005) and HE (OR = 0.43, 95% CI = 0.22-0.85, p = 0.02), but not those with ascites or non-SBP infections or undergoing large-volume paracentesis. Short-term human albumin infusion treatment could significantly decrease short-term mortality (OR = 0.67, 95% CI = 0.50-0.89, p = 0.005), but not long-term mortality. Long-term human albumin infusion treatment could not significantly decrease long-term mortality (OR = 0.72, 95% CI = 0.48-1.08, p = 0.11). In addition, human albumin infusion could significantly decrease the incidence of renal impairment (OR = 0.63, 95% CI = 0.45-0.88, p = 0.007) and ascites (OR = 0.45, 95% CI = 0.25-0.81, p = 0.007), but not infections or gastrointestinal bleeding.
CONCLUSIONS: Human albumin infusion may improve the outcomes of cirrhotic patients. However, its indications for different complications and infusion strategy in liver cirrhosis should be further explored.
摘要：
背景：人白蛋白输注可有效控制全身炎症，从而可能管理一些肝硬化相关的并发症，如自发性细菌性腹膜炎（SBP），肝性脑病(HE),和肝肾综合征.然而,其临床益处仍存在争议。
方法：EMBASE，PubMed,搜索了Cochrane图书馆数据库。关于在肝硬化患者中使用人白蛋白输注的随机对照试验（RCT）是合格的。合并死亡率和肝硬化相关并发症的发生率。还主要根据目标人群和人白蛋白输注治疗的持续时间通过亚组分析评估了人白蛋白输注对死亡率的影响。计算具有95%置信区间(CIs)的赔率比(ORs)。
结果：最终纳入42个随机对照试验。Meta分析显示，输注人白蛋白可显著降低肝硬化患者的病死率（OR=0.81，95%CI=0.67～0.98，p=0.03）。亚组分析表明，人白蛋白输注可以显着降低SBP（OR=0.36，95％CI=0.20-0.64，p=0.0005）和HE（OR=0.43，95％CI=0.22-0.85，p=0.02）的肝硬化患者的死亡率。但不包括腹水或非SBP感染或接受大量穿刺的患者。短期人白蛋白输注治疗可显著降低短期死亡率(OR=0.67,95%CI=0.50-0.89,p=0.005),但不是长期死亡率。长期人白蛋白输注治疗不能显著降低长期死亡率(OR=0.72,95%CI=0.48-1.08,p=0.11)。此外,人白蛋白输注可以显着降低肾损害（OR=0.63，95％CI=0.45-0.88，p=0.007）和腹水（OR=0.45，95％CI=0.25-0.81，p=0.007）的发生率，但不是感染或消化道出血。
结论：人白蛋白输注可以改善肝硬化患者的预后。然而,应进一步探讨肝硬化不同并发症的适应证和不同的输液策略。
方法：EMBASE，PubMed,搜索了Cochrane图书馆数据库。关于在肝硬化患者中使用人白蛋白输注的随机对照试验（RCT）是合格的。合并死亡率和肝硬化相关并发症的发生率。还主要根据目标人群和人白蛋白输注治疗的持续时间通过亚组分析评估了人白蛋白输注对死亡率的影响。计算具有95%置信区间(CIs)的赔率比(ORs)。
结果：最终纳入42个随机对照试验。Meta分析显示，输注人白蛋白可显著降低肝硬化患者的病死率（OR=0.81，95%CI=0.67～0.98，p=0.03）。亚组分析表明，人白蛋白输注可以显着降低SBP（OR=0.36，95％CI=0.20-0.64，p=0.0005）和HE（OR=0.43，95％CI=0.22-0.85，p=0.02）的肝硬化患者的死亡率。但不包括腹水或非SBP感染或接受大量穿刺的患者。短期人白蛋白输注治疗可显著降低短期死亡率(OR=0.67,95%CI=0.50-0.89,p=0.005),但不是长期死亡率。长期人白蛋白输注治疗不能显著降低长期死亡率(OR=0.72,95%CI=0.48-1.08,p=0.11)。此外,人白蛋白输注可以显着降低肾损害（OR=0.63，95％CI=0.45-0.88，p=0.007）和腹水（OR=0.45，95％CI=0.25-0.81，p=0.007）的发生率，但不是感染或消化道出血。
结论：人白蛋白输注可以改善肝硬化患者的预后。然而,应进一步探讨肝硬化不同并发症的适应证和不同的输液策略。
