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

开发修饰氨基酸代谢物的肠外溶液以改善肝硬化患者的营养状况

基本信息

批准号：
62480285
负责人：
KANEMATSU Takashi
金额：
$ 3.14万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1987
资助国家：
日本
起止时间：
1987 至 1989
项目状态：
已结题

项目摘要

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.

肝硬变患者一般处于营养不良状态，本研究对肝硬变患者在肝脏手术前进行了14天的S肠外营养，上臂肌肉体积增加，脂肪组织厚度增加。为探讨支链氨基酸浓缩液(BCAA)对大手术后肝硬变患者营养状况的影响及预防术后肝性脑病的发生，本研究探讨了支链氨基酸浓缩液(BCAA)对肝硬变患者营养状况的影响及预防术后肝性脑病的发生。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。由于BCAA与AAA的摩尔比被认为是患者营养状况的指标之一，因此，该液对肝硬变患者的体重变化、残肝再生、肝功能恢复等可能具有一定的营养价值。对70%肝切除大鼠给予支链氨基酸富集液、多巴胺和加巴松的肝细胞有丝分裂指数、血浆氨基酸浓度和血清生化指标进行了研究。尽管多巴胺对肝再生有促进作用，但在服用支链氨基酸浓缩液或加巴酯的大鼠中没有观察到任何影响。