Habu Daiki, Nishiguchi Shuhei, Nakatani Shinji, Lee Chulyoo, Enomoto Masaru, Tamori Akihiro, Takeda Tadashi, Ohfuji Satoko, Fukushima Wakaba, Tanaka Takashi, Kawamura Etsuji, Shiomi Susumu
Department of Hepatology, Graduate School of Medicine, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
Hepatogastroenterology. 2009 Nov-Dec;56(96):1719-23.
BACKGROUND/AIMS: We designed a randomized trial to examine whether increase or preservation of serum albumin levels was attained with administration of branched-chain amino acid (BCAA) granules for compensated cirrhosis, compared with decompensated cirrhosis.
Sixty-five patients with HCV-related cirrhosis with serum albumin level less than 4.0 g/dl were enrolled in this study. Half of the patients were randomly assigned to receive 14.22 g/day of BCAA granules orally, and half were assigned to a control group. Patients were evaluated at entry and at 1-year intervals for at least 2 years. The parameters were divided into 3 categories. Class 1 was decompensated cirrhosis with serum albumin level less than 3.5 mg/dl. Class 2 was compensated cirrhosis with serum albumin level over 3.6 mg/dl and molar ratio of BCAA to tyrosine (BTR) less than 4. Class 3 was compensated cirrhosis with serum albumin level over 3.6 mg/dl and BTR over 4.
In class 1 and class 2, the BCAA group exhibited significantly higher rates of maintaining serum albumin level than the control group for 2 years. In contrast, there was no significant difference between the BCAA group and control group in rate of maintaining serum albumin levels in class 3.
Those results suggested that if cirrhotic patients were in the compensated stage at the entry but with lower BTR, as for decompensated cirrhosis, oral BCAA supplementation might be effective in maintaining serum albumin level for 2 years.
背景/目的：我们设计了一项随机试验，以研究与失代偿期肝硬化相比，给予支链氨基酸（BCAA）颗粒剂治疗代偿期肝硬化是否能提高或维持血清白蛋白水平。
本研究纳入了65例血清白蛋白水平低于4.0 g/dl的丙型肝炎相关性肝硬化患者。其中一半患者被随机分配口服14.22 g/天的BCAA颗粒剂，另一半被分配到对照组。在入组时以及之后至少2年的时间里，每隔1年对患者进行评估。参数分为3类。第1类是血清白蛋白水平低于3.5 mg/dl的失代偿期肝硬化。第2类是血清白蛋白水平超过3.6 mg/dl且支链氨基酸与酪氨酸摩尔比（BTR）低于4的代偿期肝硬化。第3类是血清白蛋白水平超过3.6 mg/dl且BTR超过4的代偿期肝硬化。
在第1类和第2类患者中，BCAA组维持血清白蛋白水平的比例在2年时间里显著高于对照组。相比之下，在第3类患者中，BCAA组和对照组在维持血清白蛋白水平的比例上没有显著差异。
这些结果表明，如果肝硬化患者在入组时处于代偿期但BTR较低，那么对于失代偿期肝硬化患者，口服补充BCAA可能在2年时间里有效维持血清白蛋白水平。
