Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Iwate, Japan.
J Gastroenterol Hepatol. 2010 Sep;25(9):1550-5. doi: 10.1111/j.1440-1746.2010.06306.x.
This prospective control study examined whether supplementation with branched-chain amino acid (BCAA)-enriched nutrients can help maintain and improve residual liver function and nutritional status in cirrhotic patients with hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA).
Subjects were 49 patients with hepatitis C-related HCC who underwent RFA. Two groups were formed: BCAA group (BCAA-enriched nutrient, aminoleban EN) and controls (standard diet only). Event-free survival rate, liver function tests, and Short Form (SF)-8 scores were evaluated in both groups before and one year after RFA. Energy metabolism using indirect calorimetry was measured before and after 3 months.
Complete data were obtained from 35 patients (BCAA group, n = 20; controls, n = 15). Six events (death, recurrence of HCC, rupture of esophageal varices and liver failure) occurred during the observation period, but frequencies of these events did not differ between groups. Event-free survival rate tended to be higher in the BCA group than in controls. Among the parameters of liver function, serum albumin level was only significantly increased over 6 months, and remained at similar values for one year (P < 0.05). SF-8 scores for general health, physical functioning, and social functioning were significantly elevated in the BCAA group (P < 0.05). Non-protein respiratory quotient was significantly improved in the BCAA group (P < 0.01).
Supplementation with BCAA-enriched nutrients for one year in cirrhotic patients with HCC after RFA therapy can perform safety and improve both nutritional state and quality of life.
本前瞻性对照研究旨在探讨富含支链氨基酸（BCAA）的营养素补充是否有助于维持和改善接受射频消融（RFA）治疗后的肝癌合并肝硬化患者的剩余肝功能和营养状况。
本研究共纳入 49 例接受 RFA 治疗的丙型肝炎相关 HCC 患者。将患者分为两组：BCAA 组（BCAA 强化营养素，aminoleban EN）和对照组（仅给予标准饮食）。在 RFA 前后一年分别评估两组的无事件生存率、肝功能检查和 SF-8 评分。在 RFA 前后 3 个月分别测量间接热量法检测的能量代谢。
35 例患者（BCAA 组 20 例，对照组 15 例）获得完整数据。观察期间共发生 6 例事件（死亡、HCC 复发、食管静脉曲张破裂和肝功能衰竭），但两组之间这些事件的发生率无差异。BCAA 组的无事件生存率倾向于更高。在肝功能参数中，血清白蛋白水平仅在 6 个月时显著升高，并在 1 年内保持相似值（P<0.05）。BCAA 组的 SF-8 评分在一般健康、身体功能和社会功能方面均显著升高（P<0.05）。BCAA 组的非蛋白呼吸商显著改善（P<0.01）。
在接受 RFA 治疗后的 HCC 合并肝硬化患者中，补充富含 BCAA 的营养素 1 年可确保安全，并改善营养状况和生活质量。
