Dioguardi F S, Brigatti M, Dell'Oca M, Ferrario E, Abbiati R
Gruppo Studi Apporti Metabolici, Università degli Studi di Milano, Italy.
Clin Physiol Biochem. 1990;8(2):101-7.
Liver cirrhosis is characterized by low plasma levels of branched chain amino acids (BCAA) and high concentrations of aromatic amino acids (AAA), and this imbalance has been implicated in the pathogenesis of hepatic encephalopathy by the synthesis of altered neurotransmitters. Contrasting results on intravenous or oral BCAA efficacy and metabolic impact have already been reported, but studies reported in the literature were never longer than a few weeks. After oral administration of BCAA and a standard diet to 28 cirrhotic patients for 1 year, no modifications in plasma concentrations of BCAA could be observed up to 3 months of therapy. Our data and an accurate analysis of the current literature lead us to propose the hypothesis that in the impaired nitrogen metabolism following cirrhosis there are neither single metabolic presentations nor many perturbations, but numerous 'subpopulations' of patients who present a homogeneous pattern of alterations that may distinguish them in terms of therapeutic approach.
肝硬化的特征是血浆支链氨基酸（BCAA）水平低，芳香族氨基酸（AAA）浓度高，这种失衡通过合成改变的神经递质参与了肝性脑病的发病机制。关于静脉注射或口服BCAA的疗效和代谢影响，已有对比结果报道，但文献中报道的研究时长从未超过几周。对28例肝硬化患者口服BCAA并给予标准饮食1年，在治疗3个月内未观察到BCAA血浆浓度有变化。我们的数据以及对当前文献的精确分析使我们提出这样的假设：在肝硬化后受损的氮代谢中，既不存在单一的代谢表现，也不存在许多干扰因素，而是存在众多“亚群”患者，他们呈现出一种同质的改变模式，这可能在治疗方法上区分他们。
