TYROSINE METABOLISM IN PATIENTS WITH LIVER DISEASE
TYROSINE METABOLISM IN PATIENTS WITH LIVER DISEASE
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DOI：
10.1172/jci105690
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发表时间：
1967-01-01
影响因子：
15.9
通讯作者：
CONN, HO
中科院分区：
文献类型：
--
作者：
LEVINE, RJ;CONN, HO
在正常受试者和肝炎、胆道梗阻或肝硬化患者中，在空腹状态和口服酪氨酸（酪氨酸耐受试验）或苯丙氨酸（苯丙氨酸转换试验）后测定血浆酪氨酸水平。肝炎和胆道梗阻患者的空腹酪氨酸水平有轻微升高的趋势，而肝硬化患者则明显升高。肝硬化患者的酪氨酸耐量试验的特点是酪氨酸水平的增加大于正常值，并延迟恢复到空腹水平。约1/2肝炎或胆道梗阻患者和4/5肝硬化患者的苯丙氨酸转换试验结果异常。禁食的特征是空腹血浆酪氨酸水平升高，或酪氨酸水平的小幅度和延迟性增加，或两者兼而有之。肝硬化患者的苯丙氨酸转换试验结果异常与肝硬化的任何临床特征无关。与任何标准肝功能检查的结果;仅与异常NHg耐受性（门体分流试验）呈正相关。酪氨酸代谢试验似乎对肝功能的常规临床评估没有用。为诊断其他疾病而进行的酪氨酸耐量试验和苯丙氨酸转换试验可能会对肝病患者产生误导性结果。
Plasma levels of tyrosine were assayed in the fasting state and after oral administration of either tyrosine (tyrosine tolerance test) or phenylalanine (phenylalanine conversion test) in normal subjects and in patients with hepatitis, biliary obstruction, or cirrhosis. Fasting tyrosine levels tended to be slightly increased in patients with hepatitis and biliary obstruction and markedly increased in patients with cirrhosis. Tyrosine tolerance tests in patients with cirrhosis were characterized by larger than normal increments in tyrosine levels and by delayed returns toward fasting levels. The results of phenylalanine conversion tests were abnormal in approximately 1/2 of patients with either hepatitis or biliary obstruction and 4/5''s of patients with cirrhosis. Abnormalities were characterized by elevated fasting plasma tyrosine levels, or small and delayed increments in tyrosine levels, or both. Abnormal phenylalanine conversion test results in patients with cirrhosis did not correlate closely with any clinical feature of cirrhosis or. with the results of any standard liver function test; there was positive correlation only with abnormal NHg tolerance, a test of portal-systemic shunting. Tests of tyrosine metabolism do not appear to be useful for routine clinical assessment of liver function. Tyrosine tolerance tests and phenylalanine conversion tests done for purposes of diagnosis of other diseases may yield misleading results in patients with liver disease.