门静脉高压症断流术前后的血氨基酸谱及其意义

The changes and significance of plasma amino acid profile before and after disconnection in cirrhotic portal hypertension

本文对41例肝硬变门静脉高压症行断流术前后进行了血浆氨基酸谱测定,结果与正常人比较,发现肝硬变患者血浆氨基酸谱的主要特点是 BCAA 明显降低,AAA 增高,二者(支/芳)比值明显下降.支/芳比值在肝功能属 Child A 级的患者术前为2.09.术后为2.06;B 级患者术前为1.83,术后为1.52.B 级明显低于 A级,说明支/芳比值的降低反映了肝功能损害程度.手术前后比较.术后 AAA 及 BCAA 均增高,但以前者更明显.支/芳比值由术前1.98降至术后的1.6.这一变化与手术创伤及应激状态有关,并对手术的预后估计有一定意义.

From 1986 to 1990,the plasma amino acid profile (PAAP) was determined on 41 patients with cirrhotic portal hypertension before and after combined porto-azygos disconnection.The main features of PAAP in cirrhotic patients were markedly decreased levels of branched chain amino acid (BCAA) and elevated levels of aromatic amino acid (AAA) while the ratio of BCAA/AAA was significantly decreased.The ratio of BCAA/AAA in Child B patients was lower than those in Child A patients,Which showed the reduced BCAA/AAA ratio represented the degrees of inpaired hepatic function.After operation,both AAA and BCAA were incerased but the in- creasing of AAA was predominant,the ratio of BCAA/AAA was decreased from 1.98 to 1.6 after the operation.These changes were related to the ope- rative trauma and stress.The ratio of BCAA/AAA in patients with opera- tive complications were markedly lower than those without complications. The results showed that BCAA/AAA ratio of PAAP were significant in es- timation of operative prognosis.