急性病毒性肝炎患者血浆氨基酸改变的临床意义

作者用高效液相色谱法测定28例急性肝炎患者的20种血浆氨基酸值。结果表明:急性肝炎患者17种氨基酸、重症肝炎患者13种氨基酸有显著增多;支链氨基酸(BCAA)/芳香族氨基酸(AAA)克分子比值显著降低。血浆氨基酸增多以蛋氨酸最为显著,在3例胆酶分离的重症肝炎患者蛋氨酸也明显升高,这可以作为反映肝细胞坏死程度的较好指标。讨论了肝炎患者血浆氨基酸代谢紊乱的机理和氨基酸测定的临床意义。

THE CLINICAL SIGNIFICANCE OF PLASMA AMINO ACID ALTERATIONS IN PATIENTS WITH ACUTE VIRAL HEPATITIS

Twenty amino acids were determined in 28 patients with acute viral hepatitis by high performance liquid chromatography. Results showed that 17 types of amino acids were significantly increased in acute hepatitis and 13 in fulminant hepatic failure, and the BCAA/AAA molar ratio was significantly decreased in both groups of patients. Among the amino acids assayed, methionine showed the most striking increment. In 3 cases of fulminant hepatic failure with marked hyperbilirubinemia and discordantly normal SGPT levels, the methionine level was also significantly higher than normal. It may be feasible to consider the latter as an index of the extent of hepatocellular necrosis. The mechanism and clinical significance of metabolic disturbances of amino acids in patients with acute hepatitis are discussed.