血浆氨基酸水平在评价门脉高压症术后并发症中的作用(附58例报告)

The Role of Plasma Amino Acid Levels in Evaluating Postoperative Complications in Patients with Portal Hypertension (Analysis of 58 Cases)

对术前曾行氨基酸分析的５８例患者技术后有无并发症分为两组，比较支链氨基酸（ＢＣＡＡ）与芳香族氨基酸（ＡＡＡ）、蛋氨酸（ＭＥＴ）、色氨酸（ＴＲＰ）水平。结果：并发症组术前ＢＣＡＡ：ＡＡＡ比值明显低于无并发症组［（１．７１±０．４４）ｖｓ（２．３４±０．６３）］ｍｍｏｌ／Ｌ（Ｐ＜０．０１），ＭＥＴ与ＴＲＰ显著高于无并发症组，分别为［（７１．４６±１１．６９）ｖｓ（３４．８５± ６．５３）］ｍｍｏｌ／Ｌ、［（５９．５２ ± １７．２１）ｖｓ（４８，４３ ± １４．３５）］ｍｍｏｌ（Ｐ＜０，０１，Ｐ＜０．０５）。术后并发症发生率为３７．９３％（分流术组３８．８９％，断流术组３６．３６％）。提示：上述３项指标对术后并发症的预测、肝脏功能的评价。指导选择手术时机等具有重要临床意义。

preoperative patients with amino acid analysis were divided into two groups according ic existance with or without complications after operation. The levels of branched chain amino acid (BCAA) with aromatic amino acid (AAA) ratio, MET and TRP of the two groups were compared statistically. Results: In the group with complications, the preoperative BCAA/AAA ratio was lower than group without complcations(1.71±0.44 ) vs (2.34 ±0.63) mmol/L (P < 0.01 ). MET and TRP in the group with complications were higher than group without complications. The levels were (71.46 ± 11.69) vs (34.85 ±6.53)mmol/l., (59.52±17. 21) vs (48.43 ±14.35) mmol/L respectiely (P < 0.01, P <0.05 ) The incideence of postoperative complications was 37.93 % (the group of shunt was 38.89%, the group of pericardial devaseularization plus splenectomy was 36.36% ). Conclusion: The three indexes had clinical significance in the prediction of postoperative complications, evaluation of liver function and guidance of chasing operative time.