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肝切除术前支链氨基酸与酪氨酸摩尔比的意义。

Significance of the molar ratio of branched-chain amino acids to tyrosine before hepatectomy.

作者信息

Kohashi Toshihiko, Itamoto Toshiyuki, Katayama Koji, Katayama Shigeru, Hino Hiroshi, Nakahara Hideki, Tashiro Hirotaka, Asahara Toshimasa

机构信息

Second Department of Surgery, Hiroshima University School of Medicine, Hiroshima, Japan.

出版信息

Hepatogastroenterology. 2002 May-Jun;49(45):774-7.

Abstract

BACKGROUND/AIMS: To predict the degree of liver fibrosis and select a safe operative procedure, the correlation between liver fibrotic ratio and preoperative liver function variables were analyzed, and the significance of the molar ratio of branched-chain amino acids to tyrosine determined preoperatively was investigated.

METHODOLOGY

Forty-four patients with hepatectomy were enrolled in this study. Liver tissue specimens excised from the patients were stained by Azan-Mallory's method. The liver fibrotic ratio was measured using an Image Cytometer. The correlation between liver fibrotic ratio and preoperative liver function values, including the serum level of branched-chain amino acids to tyrosine, were determined.

RESULTS

The degrees of liver fibrosis (normal group, 1.4 +/- 0.7%; chronic hepatitis group, 4.5 +/- 2.8%; cirrhosis group, 8.4 +/- 2.4%) correlated significantly with preoperative liver function values such as branched-chain amino acids to tyrosine, hepaplastin test, type IV collagen 7s domain, total bilirubin, indocyanine green clearance retention rate at fifteen minutes, and platelet count. The serum level of branched-chain amino acids to tyrosine showed the most-significant correlation with the degree of liver fibrosis.

CONCLUSIONS

The serum level of branched-chain amino acids to tyrosine correlates well with the degree of liver fibrosis, and this value is a useful preoperative parameter for predicting the degree of liver fibrosis and for selecting a safe operative procedure.

摘要

背景/目的:为预测肝纤维化程度并选择安全的手术方式,分析肝纤维化比例与术前肝功能变量之间的相关性,并研究术前测定的支链氨基酸与酪氨酸摩尔比的意义。

方法

本研究纳入44例行肝切除术的患者。对患者切除的肝组织标本采用阿赞-马洛里氏法染色。使用图像细胞仪测量肝纤维化比例。确定肝纤维化比例与术前肝功能值之间的相关性,包括支链氨基酸与酪氨酸的血清水平。

结果

肝纤维化程度(正常组,1.4±0.7%;慢性肝炎组,4.5±2.8%;肝硬化组,8.4±2.4%)与术前肝功能值如支链氨基酸与酪氨酸、肝促凝血酶原激酶试验、IV型胶原7s结构域、总胆红素、15分钟时吲哚菁绿清除保留率及血小板计数显著相关。支链氨基酸与酪氨酸的血清水平与肝纤维化程度的相关性最为显著。

结论

支链氨基酸与酪氨酸的血清水平与肝纤维化程度密切相关,该值是预测肝纤维化程度及选择安全手术方式的有用术前参数。

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