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

肝硬化患者一般处于营养不良状态。在本研究中，肝硬化患者在肝手术前进行了14天的肠外营养，上臂肌肉的体积和脂肪组织的厚度增加。这些患者对手术耐受良好，术后过程平稳。接下来的研究旨在阐明支链富集氨基酸溶液（BCAA）对肝硬化大手术后患者营养状况的影响，以及预防肝硬化患者术后肝性脑病的发生。BCAA与芳香氨基酸（AAA）的摩尔比明显增加，但该溶液对术后肝性脑病的发生没有预防作用。由于BCAA与AAA的摩尔比被认为是患者营养状况的指标之一，因此该溶液对肝硬化患者可能具有一定的营养价值。实验研究了70%肝切除大鼠给予BCAA富集液、多巴胺和gabaxate后的体重变化、残肝再生率、肝细胞有丝分裂指数、血浆氨基酸浓度和血清生化指标。虽然多巴胺对肝脏再生的作用增加，但在给予bcaa富集溶液或gabaxate的大鼠中没有观察到任何影响。

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.