Unit of Internal Medicine, Alma MAter Studiorum University, Bologna, Italy.
Hepatol Res. 2008 Nov;38 Suppl 1:S93-S101. doi: 10.1111/j.1872-034X.2008.00433.x.
The liver plays a central role in the regulation of nutrition by trafficking the metabolism of nutrients, their distribution and appropriate use. Accordingly, protein-energy malnutrition is common in patients with advanced liver disease, and it is a significant prognostic factor, affecting survival, the success of liver transplantation and quality of life. Clinical guidelines for the assessment and treatment of malnutrition have been issued by International societies, suggesting that nutritional therapy should be instituted in all patients where requirements are not adequately met by diet. The supplementation of the diet with amino acids (mainly branched-chain amino acids) and trace elements may improve nutritional status, liver function and hepatic encephalopathy. Nutritional issues should be carefully considered in Liver Units treating patients with advanced cirrhosis, and long-term, carefully controlled studies are needed to better define the type of nutritional support and the amount and timing of administration.
肝脏在营养物质的代谢、分布和合理利用方面发挥着核心作用，从而调节营养。因此，晚期肝病患者中普遍存在蛋白质-能量营养不良，这是一个重要的预后因素，影响着患者的生存率、肝移植的成功率和生活质量。国际社会已经发布了关于营养不良评估和治疗的临床指南，建议对所有营养需求不能通过饮食充分满足的患者进行营养治疗。通过饮食补充氨基酸（主要是支链氨基酸）和微量元素可能会改善营养状况、肝功能和肝性脑病。在治疗晚期肝硬化的肝脏单位中，应仔细考虑营养问题，需要进行长期、精心控制的研究，以更好地确定营养支持的类型以及给予的剂量和时间。
