Poon R T-P, Yu W-C, Fan S-T, Wong J
Centre for the Study of Liver Disease and Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong, China.
Aliment Pharmacol Ther. 2004 Apr 1;19(7):779-88. doi: 10.1111/j.1365-2036.2004.01920.x.
Patients undergoing transarterial chemoembolization for hepatocellular carcinoma have advanced tumour or severe cirrhosis and frequently have associated protein-calorie malnutrition. The role of nutritional supplements for such patients is unclear.
To investigate, in a randomized controlled trial, any benefit of the long-term administration of branched chain amino acids in patients undergoing chemoembolization for hepatocellular carcinoma.
Forty-one patients received oral branched chain amino acids for up to four courses of chemoembolization and 43 patients did not receive any nutritional supplement. Morbidity, liver function, nutritional status, quality of life and long-term survival were compared between the two groups.
The administration of branched chain amino acids resulted in a lower morbidity rate compared with the control group (17.1% vs. 37.2%, P = 0.039). In particular, the group given branched chain amino acids showed a significantly lower rate of ascites (7.3% vs. 23.2%, P = 0.043) and peripheral oedema (9.8% vs. 27.9%, P = 0.034). Significantly higher serum albumin, lower bilirubin and a better quality of life were observed after chemoembolization in the group given branched chain amino acids. However, there was no significant difference in survival between the two groups.
Nutritional supplementation with oral branched chain amino acids is beneficial in increasing the serum albumin level, reducing the morbidity and improving the quality of life in patients undergoing chemoembolization for inoperable hepatocellular carcinoma.
接受经动脉化疗栓塞治疗肝细胞癌的患者存在肿瘤进展或严重肝硬化，且常伴有蛋白质 - 热量营养不良。营养补充剂对此类患者的作用尚不清楚。
在一项随机对照试验中，研究长期给予支链氨基酸对接受肝细胞癌化疗栓塞治疗患者的益处。
41例患者接受口服支链氨基酸，最多进行四个疗程的化疗栓塞，43例患者未接受任何营养补充剂。比较两组患者的发病率、肝功能、营养状况、生活质量和长期生存率。
与对照组相比，给予支链氨基酸可降低发病率（17.1%对37.2%，P = 0.039）。特别是，给予支链氨基酸的组腹水发生率显著较低（7.3%对23.2%，P = 0.043）和外周水肿发生率显著较低（9.8%对27.9%，P = 0.034）。给予支链氨基酸的组在化疗栓塞后血清白蛋白显著更高、胆红素更低且生活质量更好。然而，两组之间的生存率无显著差异。
口服支链氨基酸进行营养补充有助于提高不可切除肝细胞癌化疗栓塞患者的血清白蛋白水平、降低发病率并改善生活质量。
