Abstract：
CONCLUSIONS: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
OBJECTIVE: The purpose of this article is to discuss how the structural and presumably functional integrity of albumin, as described by the concept of effective albumin concentration (eAlb), has potentially important clinical implications beyond the total albumin concentration (tAlb) routinely reported by clinical laboratories.
CONCLUSIONS: Albumin has several functions beyond its oncotic effects, including molecule binding, substance transport, detoxification actions, and serving as an antioxidant. However, there are conformational changes that occur during or following the manufacture of albumin and during its administration to patients with various disease states, such as decompensated liver disease, that often impair these functions. Such impairments are not reflected in tAlb values reported by clinical laboratories and might explain the disconnect often seen between albumin\'s proposed beneficial mechanistic functions and its less-than-predicted clinical effectiveness as noted in published studies. The concept of eAlb has been introduced to describe albumin with structural and functional integrity. Limited studies have found associations between eAlb values and patient prognostic indicators, but the techniques used to decide these effective concentrations to date are complicated and require specialized equipment and experienced researchers for proper interpretation.
CONCLUSIONS: Estimation of eAlb may provide valuable information on the functional ability of albumin beyond the tAlb reported by clinical laboratories, but more research is needed to decide how this information is best used in the clinical setting.
OBJECTIVE: The purpose of this article is to discuss how the structural and presumably functional integrity of albumin, as described by the concept of effective albumin concentration (eAlb), has potentially important clinical implications beyond the total albumin concentration (tAlb) routinely reported by clinical laboratories.
CONCLUSIONS: Albumin has several functions beyond its oncotic effects, including molecule binding, substance transport, detoxification actions, and serving as an antioxidant. However, there are conformational changes that occur during or following the manufacture of albumin and during its administration to patients with various disease states, such as decompensated liver disease, that often impair these functions. Such impairments are not reflected in tAlb values reported by clinical laboratories and might explain the disconnect often seen between albumin\'s proposed beneficial mechanistic functions and its less-than-predicted clinical effectiveness as noted in published studies. The concept of eAlb has been introduced to describe albumin with structural and functional integrity. Limited studies have found associations between eAlb values and patient prognostic indicators, but the techniques used to decide these effective concentrations to date are complicated and require specialized equipment and experienced researchers for proper interpretation.
CONCLUSIONS: Estimation of eAlb may provide valuable information on the functional ability of albumin beyond the tAlb reported by clinical laboratories, but more research is needed to decide how this information is best used in the clinical setting.
摘要：
结论：为了加快文章的发表，AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑，但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本，将在以后替换为最终文章（按照AJHP样式格式化并由作者证明）。
目的：本文的目的是讨论白蛋白的结构和可能的功能完整性，如有效白蛋白浓度(eAlb)的概念所述，除了临床实验室常规报告的总白蛋白浓度（tAlb）外，还具有潜在的重要临床意义。
结论：白蛋白除了其致癌作用外，还具有多种功能，包括分子结合，物质运输,解毒行动，作为抗氧化剂。然而,在白蛋白制造过程中或之后，以及在对各种疾病状态的患者给药过程中，都会发生构象变化，如失代偿性肝病，经常削弱这些功能。临床实验室报告的tAlb值未反映此类损伤，这可能解释了白蛋白提出的有益机制功能与其在已发表研究中指出的低于预期的临床有效性之间经常出现的脱节。已经引入了eAlb的概念来描述具有结构和功能完整性的白蛋白。有限的研究发现eAlb值与患者预后指标之间存在关联。但是迄今为止，用于确定这些有效浓度的技术很复杂，需要专门的设备和经验丰富的研究人员才能进行适当的解释。
结论：eAlb的估算可能提供有关白蛋白功能能力的有价值的信息，超出了临床实验室报告的tAlb，但是需要更多的研究来决定如何在临床环境中最好地使用这些信息。
目的：本文的目的是讨论白蛋白的结构和可能的功能完整性，如有效白蛋白浓度(eAlb)的概念所述，除了临床实验室常规报告的总白蛋白浓度（tAlb）外，还具有潜在的重要临床意义。
结论：白蛋白除了其致癌作用外，还具有多种功能，包括分子结合，物质运输,解毒行动，作为抗氧化剂。然而,在白蛋白制造过程中或之后，以及在对各种疾病状态的患者给药过程中，都会发生构象变化，如失代偿性肝病，经常削弱这些功能。临床实验室报告的tAlb值未反映此类损伤，这可能解释了白蛋白提出的有益机制功能与其在已发表研究中指出的低于预期的临床有效性之间经常出现的脱节。已经引入了eAlb的概念来描述具有结构和功能完整性的白蛋白。有限的研究发现eAlb值与患者预后指标之间存在关联。但是迄今为止，用于确定这些有效浓度的技术很复杂，需要专门的设备和经验丰富的研究人员才能进行适当的解释。
结论：eAlb的估算可能提供有关白蛋白功能能力的有价值的信息，超出了临床实验室报告的tAlb，但是需要更多的研究来决定如何在临床环境中最好地使用这些信息。
