Campollo O, Sprengers D, McIntyre N
Academic Department of Medicine, Royal Free Hospital, London, England.
Rev Invest Clin. 1992 Oct-Dec;44(4):513-8.
We studied the plasma amino acid profiles in the postabsorptive period in three groups of cirrhotic patients: stable, unstable, and with acute portal systemic encephalopathy (PSE), and compared them with a healthy control group in order to investigate the differences among the different groups and reevaluate the use of the branched-chain amino acid/aromatic amino acid (BCAA/AAA) ratio. Although plasma amino acid levels were similar to the control group, stable cirrhotics had a significantly decreased BCAA/AAA ratio (2.9 +/- 0.2) compared to the control group (3.9 +/- 0.3) (p < 0.05). Unstable cirrhotics had differences in plasma amino acid levels and the BCAA/AAA ratio was even lower (1.7 +/- 0.3) compared with stable cirrhotics and controls, respectively (p < 0.05 and p < 0.01). Patients with PSE had extreme elevations of most amino acids and showed the lowest BCAA/AAA ratio of all four groups (0.8 +/- 0.07) (p < 0.001 compared with controls). We conclude that it is possible to detect differences in plasma amino acid concentrations in different groups of cirrhotics, and that the BCAA/AAA ratio is a good index for the assessment of liver impairment. The latter could be used in the follow-up of a selected group of patients such as those undergoing major surgery or liver transplantation in whom the BCAA/AAA ratio could be used to help determine the best time for the transplant.
病情稳定的、病情不稳定的以及患有急性门体性脑病（PSE）的，并将其与健康对照组进行比较，以调查不同组之间的差异，并重新评估支链氨基酸/芳香族氨基酸（BCAA/AAA）比值的用途。尽管血浆氨基酸水平与对照组相似，但病情稳定的肝硬化患者的BCAA/AAA比值（2.9±0.2）与对照组（3.9±0.3）相比显著降低（p<0.05）。病情不稳定的肝硬化患者血浆氨基酸水平存在差异，其BCAA/AAA比值与病情稳定的肝硬化患者和对照组相比更低（分别为1.7±0.3）（p<0.05和p<0.01）。患有PSE的患者大多数氨基酸极度升高，且在所有四组中BCAA/AAA比值最低（0.8±0.07）（与对照组相比p<0.001）。我们得出结论，有可能检测到不同组肝硬化患者血浆氨基酸浓度的差异，并且BCAA/AAA比值是评估肝功能损害的良好指标。后者可用于特定患者群体的随访，如接受大手术或肝移植的患者，其中BCAA/AAA比值可用于帮助确定最佳移植时间。
