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富含支链氨基酸的营养素对射频消融治疗后肝细胞癌患者的影响:一项为期一年的前瞻性试验。

Effects of branched-chain amino acid-enriched nutrient for patients with hepatocellular carcinoma following radiofrequency ablation: a one-year prospective trial.

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Iwate, Japan.

出版信息

J Gastroenterol Hepatol. 2010 Sep;25(9):1550-5. doi: 10.1111/j.1440-1746.2010.06306.x.

Abstract

BACKGROUND AND AIM

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).

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

背景与目的

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。

方法

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。

结果

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)。

结论

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。

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