Ferenci P, Wewalka F
Infusionsther Klin Ernahr. 1980 Apr;7(2):72-8.
The amino acid solution, Aminofusin hepar, was evaluated for treatment of hepatic encephalopathy and for parenteral nutrition of patients with liver cirrhosis in correlation to changes in amino acid levels. In contrast to amino acid solutions used for the parenteral nutrition of patients without liver disease, this solution contains an increased proportion of branch chained amino acids and of arginine and ornithine, and a reduced proportion of phenylalanine, methionine, glycine and threonine. The changes in the plasma amino acid levels after infusion of this solution were measured in 4 cirrhotics. The concentration of leucine, isoleucine, valine, ornithine and arginine increased markedly, whereas phenylalanine, methionine, tyrosine, glycine and threonine decreased. The ammonia level in venous blood increased slightly. 4 cirrhotics with encephalopathy were treated for 7 days. In 3 of them the neuropsychiatric symptoms were completely reversed, whereas in the remaining 1 no clinical improvement was achieved in spite of normalization of the plasma aminogramm. In this patient a constant rise of blood ammonia was noted. The indications for special amino acid solutions in liver diseases are discussed.
对氨基酸溶液Aminofusin hepar进行了评估，以探讨其在治疗肝性脑病及用于肝硬化患者肠外营养方面与氨基酸水平变化的相关性。与用于无肝脏疾病患者肠外营养的氨基酸溶液不同，该溶液中支链氨基酸、精氨酸和鸟氨酸的比例增加，而苯丙氨酸、蛋氨酸、甘氨酸和苏氨酸的比例降低。在4例肝硬化患者中测定了输注该溶液后血浆氨基酸水平的变化。亮氨酸、异亮氨酸、缬氨酸、鸟氨酸和精氨酸的浓度显著升高，而苯丙氨酸、蛋氨酸、酪氨酸、甘氨酸和苏氨酸降低。静脉血中的氨水平略有升高。4例患有脑病的肝硬化患者接受了7天的治疗。其中3例患者的神经精神症状完全逆转，而其余1例尽管血浆氨基酸谱恢复正常，但未取得临床改善。该患者血氨持续升高。文中讨论了肝脏疾病中特殊氨基酸溶液的应用指征。
