Nespoli A, Bevilacqua G, Staudacher C, Rossi N, Salerno F, Castelli M R
Arch Surg. 1981 Sep;116(9):1129-38. doi: 10.1001/archsurg.1981.01380210013003.
We sought to determine whether false neurotransmitters (FNTs) play an important role as determinants not only of hepatic encephalopathy but also of hyperdynamic syndrome in cirrhosis. A combined biochemical and hemodynamics study of 55 bleeding cirrhotic patients was made. We evaluated the aromatic and aliphatic branched-chain amino acids and octopamine serum levels as well as the hemodynamic measurements. The results show that there is a correlation between levels of serum octopamine and aromatic amino acids and hepatic coma: the higher the octopamine level, the deeper the hepatic coma. There is also a correlation between aromatic amino acids and cardiac index and total peripheral resistance. Furthermore, when a narrowing of arteriovenous difference in oxygen occurs and oxygen consumption decreases, there is an increase not only in the level of aromatic amino acids, but also in octopamine level, suggesting an important linkage between hemodynamic and metabolic impairment.
我们试图确定假性神经递质（FNTs）是否不仅作为肝性脑病的决定因素，而且作为肝硬化高动力综合征的决定因素发挥重要作用。对55例出血性肝硬化患者进行了生化和血流动力学联合研究。我们评估了芳香族和脂肪族支链氨基酸以及去甲辛弗林的血清水平以及血流动力学测量值。结果表明，血清去甲辛弗林水平与芳香族氨基酸水平和肝昏迷之间存在相关性：去甲辛弗林水平越高，肝昏迷越严重。芳香族氨基酸与心脏指数和总外周阻力之间也存在相关性。此外，当动静脉氧差缩小且氧耗量降低时，不仅芳香族氨基酸水平升高，去甲辛弗林水平也升高，这表明血流动力学和代谢损害之间存在重要联系。
