Takeshita Shigeyuki, Ichikawa Tatsuki, Nakao Kazuhiko, Miyaaki Hisamitsu, Shibata Hidetaka, Matsuzaki Toshihisa, Muraoka Toru, Honda Takuya, Otani Masashi, Akiyama Motohisa, Miuma Satoshi, Ozawa Esuke, Fujimito Masumi, Eguchi Katsumi
The First Department of Internal Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8501, Japan.
Nutr Res. 2009 Feb;29(2):89-93. doi: 10.1016/j.nutres.2008.12.005.
Nutritional support may play an important role in management of liver cirrhosis (LC) associated with unresectable hepatocellular carcinoma (HCC). Total protein and albumin deteriorate in patients with LC undergoing trans-arterial chemoembolization (TACE). Therefore, in this study, we examined the hypothesis that short-term administration of branched-chain amino acids (BCAA) will prevent a fall in total protein and albumin in the perioperative period. The subjects were 56 patients who underwent TACE for HCC between 2004 and 2005 at Nagasaki University Hospital. The patients were randomly placed in the BCAA group (n = 28) or a control group (n = 28). The patients in the BCAA group consumed a snack containing 50 g of BCAA once a day at 10:00 pm starting 1 day before TACE and continuing until 2 weeks after TACE. A comparison of baseline and end point data showed greater decreases in the concentrations of total protein, albumin, cholinesterase, and total cholesterol and in the red blood cell count in the control group compared to the BCAA group. Ammonia levels decreased in the BCAA group and increased in the control group. Our findings indicate that a BCAA supplement taken orally as a late evening snack prevents suppression of liver function by TACE in patients with LC complicated with HCC during the 2-week period after TACE.
营养支持在与不可切除肝细胞癌(HCC)相关的肝硬化(LC)管理中可能发挥重要作用。接受经动脉化疗栓塞术(TACE)的LC患者的总蛋白和白蛋白会下降。因此,在本研究中,我们检验了以下假设:短期给予支链氨基酸(BCAA)可防止围手术期总蛋白和白蛋白下降。研究对象为2004年至2005年在长崎大学医院接受HCC-TACE治疗的56例患者。患者被随机分为BCAA组(n = 28)或对照组(n = 28)。BCAA组患者从TACE前1天开始,每天晚上10点食用一份含50 g BCAA的零食,持续至TACE后2周。基线数据与终点数据比较显示,与BCAA组相比,对照组的总蛋白、白蛋白、胆碱酯酶和总胆固醇浓度以及红细胞计数下降幅度更大。BCAA组氨水平下降,对照组氨水平上升。我们的研究结果表明,TACE术后2周内,作为夜宵口服补充BCAA可防止TACE对合并HCC的LC患者肝功能的抑制。