Development of parenteral solution of modified amino acid metabolites to improve nutritional status in patients with cirrhosis

肝硬化患者普遍处于营养不良状态，本研究中，肝硬化患者在肝脏手术前接受肠外营养14天，上臂肌肉体积和脂肪组织厚度增加。为探讨富含支链氨基酸溶液（BCAA）对肝硬化患者术后营养状况及预防肝性脑病发生的作用，我们对BCAA与芳香族氨基酸（AAA）的摩尔比明显增加，但对术后肝性脑病的发生无预防作用，BCAA/AAA摩尔比被认为是反映病人营养状况的指标之一，因此，本液对肝硬化病人可能有一定的营养价值，实验观察了术后病人的体重变化、残肝再生率、肝细胞有丝分裂指数、观察了70%肝切除大鼠给予富含支链氨基酸溶液、多巴胺和加贝酯后血浆氨基酸浓度、血清生化指标的变化。虽然多巴胺对肝再生的作用增加，但在给予富含BCAA的溶液或加贝酯的大鼠中没有观察到效果。

Patients with cirrhosis are generally in state-of malnutrition.In this study, patients with cirrhosis had parenteral nutrition for 14 day s prior to hepatic surgery, and volumes of muscle in the upper arm and thickness of the fatty tissue were increased. These patients tolerated the procedure well and had uneventful postoperative course.Next investigation was carried out to clarify the effect of branched chain enriched amino acid solution (BCAA) on nutritional status of patients with cirrhosis after major surgery and prevention of occurrence of postoperative hepatic encephalopathy in these patients.The molar ration between BCAA and aromatic amino acids (AAA) was significantly increased, but this solution did not have preventive effect on the occurrence of hepatic encephalopathy after surgery.Since the molar ration between BCAA and AAA is considered one of the indicators of nutritional status in patients, this solution may have some nutritional valud in patients with cirrhosis.Experimentally, weight change, renerative rate of the remnant liver, mitotic index of hepatocytes, plasma amino acid concentrations, serum biochemistry were investigated in 70% hepatectomized rats those were given BCAA enriched solution, dopamine and gabaxate. Although dopamine showed increased effect on hepatic regeneration, no effect was observed in rats given BCAA-enriched solution or gabaxate.