Department of Internal Medicine, Osaka Koseinenkin Hospital, Osaka, Japan.
Hepatol Res. 2007 Aug;37(8):615-9. doi: 10.1111/j.1872-034X.2007.00095.x. Epub 2007 May 22.
Disorders of protein metabolism in liver cirrhosis can affect prognosis or cause complications. Treatment with branched-chain amino acid (BCAA) and zinc supplements has been shown to be effective against abnormal nitrogen metabolism in liver cirrhosis. There are, however, few studies on the effects of combining these supplements. In this study, the effect of combining BCAA and zinc treatment in cirrhosis was investigated.
Forty patients with liver cirrhosis who had blood albumin levels of 3.5 g/dL or less and blood zinc levels of 70 mug/dL or less were randomized to receive either BCAA alone or a combination of BCAA and zinc supplements. Blood albumin, the Fischer ratio, and ammonia levels were compared over 5-6 months of treatment.
In the combination group, the post/pre treatment change ratio in blood ammonia levels decreased significantly (0.87 +/- 0.26 vs. 1.22 +/- 0.38, P = 0.0033), and the change ratio in the Fischer ratio increased significantly (1.22 +/- 0.29 vs. 1.08 +/- 0.16, P = 0.0165) in comparison with the BCAA monotherapy group. The change ratio in blood albumin levels showed no significant difference between the groups (1.01 +/- 0.07 vs. 1.03 +/- 0.08, P = 0.4646).
More improvement in disorders of nitrogen metabolism in liver cirrhosis occurred after administration of BCAA with zinc than after BCAA alone over 5-6 months of treatment. Further investigation is necessary to determine mechanisms of the action and longer-term clinical efficacy.
肝硬化患者的蛋白质代谢紊乱可影响预后或导致并发症。支链氨基酸（BCAA）和锌补充剂的治疗已被证明可有效治疗肝硬化的氮代谢异常。然而，关于联合使用这些补充剂的研究很少。本研究旨在探讨联合使用 BCAA 和锌治疗肝硬化的效果。
将 40 名血白蛋白水平<3.5g/dL 且血锌水平<70μg/dL 的肝硬化患者随机分为单独接受 BCAA 或 BCAA 和锌补充剂联合治疗。比较治疗 5-6 个月后血白蛋白、Fischer 比值和血氨水平的变化。
联合治疗组血氨水平的治疗前后变化比显著降低（0.87±0.26 对 1.22±0.38，P=0.0033），Fischer 比值的变化比显著升高（1.22±0.29 对 1.08±0.16，P=0.0165），与 BCAA 单药治疗组相比。两组间血白蛋白水平的变化比无显著差异（1.01±0.07 对 1.03±0.08，P=0.4646）。
与单独使用 BCAA 相比，在 5-6 个月的治疗期间，联合使用 BCAA 和锌可更有效地改善肝硬化患者的氮代谢紊乱。需要进一步研究以确定其作用机制和长期临床疗效。
