口服支链氨基酸对心力衰竭合并低蛋白血症患者血清白蛋白水平和心功能的影响

Effects of oral branched-chain amino acids on serum albumin levels and cardiac function in patients with heart failure and hypoalbuminemia

目的:探讨口服支链氨基酸(branched-chain amino acids,BCAAs)对心力衰竭合并低蛋白血症患者血清白蛋白和心功能的影响。方法:纳入符合条件的心力衰竭合并低蛋白血症患者40例,随机分为实验组(n=20)和对照组(n=20),两组均给予常规抗心力衰竭药物治疗,实验组在此基础上给予BCAAs口服,治疗时间为30 d。以心胸比(cardiothoracic ratio,CTR)评价心功能,检测治疗前后血清白蛋白等水平变化。结果:两组治疗前血清白蛋白,CTR差异无统计学意义(P>0.05);实验组治疗后血清白蛋白[(3.45±0.42) g/dL]较治疗前[(3.0±0.4) g/dL]和对照组治疗后[(3.11±0.55) g/dL]显著升高(P<0.05)。对照组治疗前后血清白蛋白比较差异无统计学意义(P>0.05);实验组治疗后CTR[(60.1±8.3)%]较治疗前[(62.3±8.4)%]和对照组治疗后[(62.2±8.2)%]降低(P<0.05)。对照组治疗前后CTR比较差异无统计学意义(P>0.05);血清白蛋白的变化值与胆碱酯酶变化值呈正相关(r=0.76,P=0.03),与体重变化值(r=-0.74,P=0.04)以及CRT变化值(r=-0.61,P=0.01)呈负相关。结论:心力衰竭合并低蛋白血症患者口服BCAAs能提高血清白蛋白水平,改善心功能。

Objective: To determine the effects of supplementation with oral branched-chain amino acids (BCAAs) in serum albumin and cardiac function in heart failure patients with hypoalbuminemia. Methods: Forty heart failure patients with hypoalbuminemia were enrolled in our study. They were divided into experimental group (n=20) and control group (n=20). They all received recommended heart failure therapy, and BCAAs were administrated to experimental group. The during of the treatment is 30 days. Cardiothoracic ratio (CTR) were used for evaluate the cardiac function, the serum albumin was examined. Results: There was no significant difference in serum albumin and CTR between the two groups before treatment, P>0.05. Serum albumin in the experimental group after the treatment significantly increased than before and that in the control group [(3.45±0.42) g/dL vs (3.0±0.4) g/dL and (3.11±0.55) g/dL] and did not change in controls. CTR significantly decreased in the experimental group than before and that in the control group [(60.1±8.3)% vs (62.3±8.4)% and (62.2±8.2)%] and did not change in controls. Changes in the serum albumin level were positively correlated with changes in the cholinesterase level (r=0.76, P=0.03) and negatively correlated with changes in body weight (r=-0.74, P=0.04) and CTR (r=-0.61, P=0.01). Conclusion: Heart failure patients with hypoalbuminemia supplemented with BCAAs showed increased serum albumin and decreased CTR.