肝细胞肝癌患者血浆氨基酸水平与Child-pugh分级的变化及分析

Analysis of serum amino acid and Child-pugh classification in patients of hepatocellular carcinoma

目的检测不同Child-pugh分级肝癌患者血清中氨基酸的变化,并探讨其临床意义。方法使用氨基酸分析仪对15例健康人和70例肝细胞肝癌患者的血浆游离氨基酸进行测定,并按照Child-pugh分级的不同将其分为三组:Child A级34例,Child B级25例及Child C级11例,分析其血中氨基酸水平。结果肝癌患者血中牛磺酸,苏氨酸,色氨酸,精氨酸及支链氨基酸和芳香族氨基酸比值水平明显降低(P<0.01),血中蛋氨酸,异亮氨酸,酪氨酸,苯丙氨酸,脯氨酸水平则明显升高(P<0.05)。对于不同肝功能分级的病人来说,随着肝脏储备功能的下降,血浆中的支链氨基酸和芳香族氨基酸比值(2.82±0.78,2.16±0.86,1.83±0.57)明显下降(P<0.01),而蛋氨酸(45.11±9.97,52.07±14.06,59.74±20.26)升高(P<0.05),酪氨酸(80.03±24.72,108.15±34.16,110.16±28.53)及苯丙氨酸(71.05±23.60,98.34±37.01,84.89±37.55)明显升高(P<0.01)。结论Child-pugh分级不同的原发性肝癌患者血浆氨基酸有明显的紊乱,对肝癌的诊断和治疗具有一定的临床意义。

Objective To study the concentrations of the changes of serum free amino acids in hepatoeellular carcinoma patients of different ehild-pugh seores.Methods We use amino acid analyzer to detect the plasma amino acid levels in 15 healthy people and 70 patients.Aeeording to Child-pugh classification,it was divided into three groups： Child A grade of 34 eases, Child B grade of 25 eases and Child C grade of 11 eases, and analyzed their blood levels of amino acids. Results The results showed that in hepatoeellular carcinoma patients, plasma tanrine, threonine, tryptophan, arginine and the ratio of branched-chain amino acids（ BCAA）to aromatic amino acids（AAA） were lowered significantly（ P 〈 0.01 ）, while plasma methionine, isoleueine, tyrosine, phenylalanine, proline were higher significantly（ P 〈 0. 05）. To three groups of Child-pugh classification, plasma of the ratio of BCAA to AAA（2.82 ± 0. 78,2.16 ±0.86, 1.83 ± 0.57）was reduced significantly（ P 〈 0.01） ,the plasma methionine（45.11 ± 9.97,52.07 ± 14.06,59.74 ± 20.26） was higher（ P 〈 0.05）, tyrosine（80.03 ± 24.72,108.15±34.16,110.16 ± 28.53 ） and phenylalanine（71.05 ± 23.60,98.34 ±37. 01,84.89± 37.55） were increased significantly（ P 〈 0.01 ）. Conclusion It indicates that the analysis of the serum free amino acids in hepatocelhdar carcinoma patients of different child-pugh scores has important value for clinical diagnosis and cure treatment.