肝炎后肝硬变患者脑脊液游离氨基酸谱的研究与探索

FREE AMINO ACID IMBALANCE IN CEREBROSPINAL FLUID OF THE PATIENTS POST-HEPATITIS CIRRHOSIS

本文对40例肝炎后肝硬变、13例正常人的脑脊液中16种氨基酸水平进行了检测,并同时检测了血清中氨基酸水平.结果表明:肝炎后肝硬变患者血浆氨基酸谱与脑脊液氨基酸谱完全不同.作者对肝炎后肝硬变患者脑脊液中氨基酸代谢的特点和失衡机理进行了探讨,并探讨了测定脑脊液中氨基酸水平的临床意义:①鉴别肝性昏迷和非肝性昏迷.②对于判定肝组织损伤程度,判定肝性脑病发生率和判定肝硬变预后较血清氨基酸敏感.③指导临床应用支链氨基酸的用时、用法和用量.

There have been many reports regarding the changes of amino acids in plasma of the patients with post-hepatitis cirrhosis, but there are few about the changes of amino acids in cere-brospinal fluid of the patients with the disease. In this study sixteen amino acids in the plasma and cere-brospinal fluid of 40 patients with post-hepatitis cirrhosis and 13 normal persons were simultaneously tested . The result showed :①The amino acid composition in plasma was different from that in cerebrpspinal fluid of the same patient. ②The amino acid composition in cerebrospinal fluid of normal person was the same as that reported by other scholars. ③The character and mechanism of disturbance of the amino acid metabolism in the cerebrospina] fluid of patients with post-hepatitis cirrhosis were discussed .④The clinical significance of testing the free amino acids in cerebrospinal fluid was discussed . First, it may be used to distinguish hepatic coma from an-hepatic coma. Second,it is a more sensitive and valuable index than plasma amino acids in evaluating the damage extent of liver tissue3 in prejudging the occurrence rate of hepatic coma and the prognosis of cirrhosis. Third,it offered a scientific basis for the therapy of hepatic coma with BCAA. On the basis of changes of B/A amino in cerebrospinal fluid,the dosage,time and way of BCAA usage was determined. And the mechanism of therapy of hepatic coma with BCAA was exploited.