Controversies regarding albumin therapy in cirrhosis.

Therefore, serum albumin levels are reduced in acute and/or chronic liver disease.

因此，在急性及/或慢性肝病中，血清白蛋白水平会降低。

In cirrhosis, low levels of albumin predict the outcome.

在肝硬化患者中，白蛋白水平低预示着预后不良。

In advanced cirrhosis, the quality of albumin is decreased due to high oxidative stress and a proinflammatory state.

在晚期肝硬化患者中，由于高氧化应激和促炎状态，白蛋白的质量降低。

Therefore, the administration of i.v. albumin would seem to be of pathophysiological relevance and benefit.

因此，静脉注射白蛋白的使用似乎具有病理生理学的相关性和益处。

Yet, the questions that remain are who, when, how much, and how often.

然而，仍然存在的问题是哪些患者、何时、使用多少剂量以及多久使用一次。

While albumin infusion is recommended after large-volume paracentesis, at diagnosis of spontaneous bacterial peritonitis, in acute kidney injury, and in hepatorenal syndrome, the amount and schedule of albumin to be administered require refinement, particularly given complications related to volume overload that have become increasingly apparent.

尽管在大量腹腔穿刺后、自发性细菌性腹膜炎的诊断时、急性肾损伤和肝肾综合征时推荐使用白蛋白输注，但白蛋白的用量和给药计划仍需改进，特别是考虑到与容量超负荷相关的并发症已变得越来越明显。

Other indications for albumin such as infections other than spontaneous bacterial peritonitis, hyponatremia, HE, prevention of poor outcomes in hospitalized, and in outpatients with cirrhosis are still debated.

其他使用白蛋白的指征，如自发性细菌性腹膜炎以外的感染、低钠血症、肝性脑病、住院患者不良结果的预防以及门诊肝硬化患者的预防，仍存在争议。

The results of studies in these settings are either negative, controversial, or inconclusive.

这些环境下的研究结果要么是负面的，要么存在争议，或者结论不明确。

This sheds some doubts regarding the use of albumin as a "one size fits all" strategy.

这让人对将白蛋白作为一种“一刀切”的策略使用产生了一些疑问。

The indication and patient selection are crucial and not always intuitive.

适应症和患者选择至关重要，但并不总是直观的。

The amount and frequency also seem to play a role in the success or failure of albumin.

白蛋白治疗的成功或失败似乎也与剂量和频率有关。

This review will critically discuss the evidence and underline areas where there are indications for albumin use and others where evidence is still insufficient and will have to await the development/results of randomized controlled trials.

本综述将批判性地讨论证据，并强调有使用白蛋白指征的领域，以及证据仍然不足、尚需等待随机对照试验的发展/结果的领域。