Risk Factors Of The Decline In Human Serum Albumin Of The Patientswho Had Malignant Obstructive Jaundice That Undergwent PTCD

OBJECTIVE:The aim of this study is to evaluate the risk factors of the decline in humanserum albumin of the patients who have malignant obstructive jaundice thatundergwent proper surgical treatment and explain the mechanism.METHODS:I searched the patient database of China-Japan Union Hospital and found69patients who had malignant obstructive jaundice (for example,Klatskin’s Tumor)thatundergone PTCD from May,2010to October,2014.There were42patients whoseserum albumin had dropped and27patients whose were not.I conducted acase-control study to evaluate the risk factors of the decline of the human serumalbumin.The candidates of the risk factors were age,sex,drinkingalcohol,prealbumin,TBIL,DBIL,AST,ALT,time before undergoing PTCD and energyintake.Data were analysed using Student’s T-test and chi-square test.RESULTS:(1)poor energy intake（<25kcal/(kg d））and malnutrition were the risk factors，the loss of albumin in bile may be one of the mechanism that caused decline ofHSA；(2)liver cell injury was not a risk factor;(3)the mean of ALT,AST,TBIL,DBILwere significantly dropped (P<0.05)3days afer ungergoning PTCD,suggested thatPTCD was effective for biliary obstruction;(4)The HSA had dropped significantlyafter undergoing PTCD.CONCLUSIONS:(1)PTCD was an effective way to treat malignant biliary obstruction;(2)malnutrition(prealbumin<180mg/L, P<0.001，OR=7.273,95%CI=（2.380,22.225）)and poor energy intake (<25kcal/(kg·d),P=0.037,OR=4.000,95%CI=（1.026,15.599）)were the risk factors of the drop of HSAafter PTCD;(4)the loss of albumin in bile may be one of the mechanism that caused decline of HSA.