【摘要】 脓毒症导致的高病死率始终是重症监护病房（ICU）面临的最严峻挑战。其诱发的全身炎症反应、组织缺氧及复苏治疗中的液体过负荷等，共同破坏了血管内皮糖萼（EGL）屏障，导致严重的毛细血管渗漏，进而加剧组织水肿与器官功能障碍。遗憾的是，临床上一直缺乏能实时、精准识别这种微循环崩溃的可靠生物标志物。近年来，血细胞比容（HCT）与血清白蛋白（Alb）差值（HCT与Alb差值）开始受到关注，它能同步反映血液浓缩与内皮通透性的变化，展现出了优秀的临床评估潜力。本文通过梳理最新的国内外研究，解析了HCT与Alb差值的动态变化在脓毒症组织屏障损伤中的重要作用，同时也详细探讨了该指标在脓毒症早期诊断、休克类型鉴别、死亡风险预测及液体复苏指导中的应用现状与前景，旨在为临床医生提供一个新的决策参考视角。更多还原

【Abstract】 The high mortality rate associated with sepsis remains one of the most formidable challenges facing intensive care unit(ICU). The systemic inflammatory response it induces, combined with tissue hypoxia and fluid overload during resuscitation therapy, collectively disrupts the vascular endothelial glycocalyx layer(EGL) barrier. This leads to severe capillary leakage, further exacerbating tissue edema and organ dysfunction. Unfortunately, there has been a persistent lack of reliable biomarkers capable of real-time, precise identification of this microcirculatory collapse in clinical settings. In recent years, the hematocrit(HCT) and serum albumin(Alb) difference(HCT and Alb difference) has gained attention for its ability to simultaneously reflect changes in blood concentration and endothelial permeability, demonstrating significant potential for clinical assessment. This paper reviews the latest domestic and international research to thoroughly analyze the pivotal role of HCT and Alb difference in the pathophysiological progression of sepsis. It also comprehensively examines the current applications and future prospects of this indicator in early sepsis diagnosis, shock type differentiation, mortality risk prediction, and fluid resuscitation guidance, aiming to provide clinicians with a novel decision-making perspective.更多还原