尿毒症患者血浆游离氨基酸谱

本文报告76例尿毒症患者血浆游离氨基酸谱。结果表明:未透析组的必需氨基酸/非必需氨基酸、酪氨酸/苯丙氨酸、缬氨酸/甘氨酸、丝氨酸/甘氨酸的比值均明显低于正常对照组;腹膜或血液透析组经透析后,虽然部分氨基酸有所纠正,但有部分必需氨基酸较透析前有所下降,上述四项指标仍明显低于正常对照组。透析治疗后,氨基酸谱可能仍为异常。因此,必须保证蛋白质摄入的量和质或氨基酸的补充。讨论了尿毒症患者血浆游离氨基酸谱改变的机理及其测定的临床意义。

PLASMA AMINO ACID CONCENTRATIONS IN UREMIC PATIENTS

Plasma concentrations of 22 amino acids were determined by reversed-phase high performance liquid chromatography (RP-HPLC) in 76 uremic patients. A group of 40 healthy subjects served as controls. The results showed that in 33 patients who had not received dialysis therapy, the ratios of essential to non- essential amino acids (EA/NEA), tyrosine to phenylalanine (Tyr/Phe), valine to glycine (Val/Gly) and serine to glycine (Ser/Gly)were all significantly lower than those in the normal control group. In 37 patients who had been treated by peritoneal dialysis, and 6 patients by maintenance hemodialysis, all the 4 ratios of EA/NEA, Tyr/Phe, Val/Gly and Ser/Gly were still significantly lower than those in the normal control group in spite of the fact that certain plasma amino acid concentrations had already been corrected by dialysis. After dialysis therapy, the plasma amino acid concentrations might still be abnormal. Therefore, adequate protein intake or amino acid supplement should be provided. The mechanism and clinical significance of changes in plasma concentrations of amino acids in uremic patients are discussed.