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A study of real time liver function assay -Amino acid utility index and protein synthetic rate-

实时肝功能测定研究-氨基酸效用指数和蛋白质合成率-

基本信息

批准号：
01570737
负责人：
ASANO Takehide
金额：
$ 1.02万
依托单位：
Chiba University School of Medicine Department of Surgery (II)
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

Surgical tissue injury accelerates the transfer of amino acids from skeletal muscle to the liver for protein synthesis required for the maintenance of immunocompetence and wound healing. From the experimental studies, hepatic amino acids clearance rate, which was expressed by measuring amino acid concentration in pre and post hepatic blood flow, was concluded as a reliable index of the severity of acute ischemic liver injury. For clinical measurement of this function, we developed a new indicator, the amino acids utility index (AAUI) , by using the rate of muscle release of amino acids (m-RR) and the rate of central plasma clearance of amino acids (CPCR-AA). They are the indices of muscle proteolysis and whole body protein turnover, and AAUI is expressed by the formula. AAUI (ml/micromol)=CPCR-AA/m-RR The value of m-RR as well as CPCR-AA were increased in surgical patients on the 2nd post operative day. The value of AAUI was correlated well with the size of hepatectomy. And it might be a good index for the real time liver function. In the cases of post hepatic liver disorder, AAUI decreased promptly with liver functional damages even in the period of normal data of other liver function indices including arterial ketone body ratio. Hepatic protein synthesis rate (HPS), which was directly measured on needle biopsied liver, was also assessed in hepatectomy patients. It suggested that hepatic functional reserve could be supposed by the value of HPS, since the HPS of liver unit has a upper limit even in the situation of increasing whole body protein requirement such as post hepatectomy. For instances, HPS of cirrhotic changed livers are already accelerated at pre operation due to severity of cirrhosis it and meant these livers have poor functional reserve. Measuring HPS might be a good method to evaluate hepatic functional reserve.

外科组织损伤加速了氨基酸从骨骼肌到肝脏的转移，以合成维持免疫活性和伤口愈合所需的蛋白质。实验结果表明，肝氨基酸清除率是反映急性缺血性肝损伤严重程度的可靠指标，可通过测定肝血流中氨基酸浓度来表示。为了临床测量这一功能，我们开发了一种新的指标--氨基酸利用指数(AAUI)，它利用肌肉氨基酸释放率(m-RR)和中心血浆氨基酸清除率(CPCR-AA)。它们是肌肉蛋白质分解和全身蛋白质周转的指标，AAUI由公式表示。AAUI(ml/micromol)=Cpr-Aa/m-Rr，手术患者术后第2天m-RR值和CPCRAA值均升高。AAUI值与肝切除大小有良好的相关性。可作为实时监测肝功能的良好指标。在肝后性肝病患者中，即使在其他肝功能指标包括动脉血酮体比正常期，AAUI也随着肝功能损害而迅速下降。肝切除患者的肝脏蛋白质合成率(HPS)也被评估，这是直接在针吸活检肝脏上测量的。提示肝单位HPS即使在肝切除后等全身蛋白质需要量增加的情况下也有上限，故可用HPS值来推测肝脏储备功能。例如，由于肝硬变的严重程度，肝硬变的HPS在术前就已经加速，这意味着这些肝脏的功能储备很差。HPS测定可能是评价肝脏储备功能的一种较好的方法。