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目的 通过检测慢性重型肝炎患者的血清氨基酸浓度 ,分析其血清氨基酸谱的特点 ,为临床治疗慢性重型肝炎提供理论基础。方法 使用4400型氨基酸自动分析仪测定50例慢性重型肝炎患者血清氨基酸浓度 ,对其氨基酸谱进行分析。 结果 慢性重型肝炎患者血清蛋氨酸、酪氨酸、苯丙氨酸浓度显著增高 ,亮氨酸、异亮氨酸、缬氨酸浓度和芳香氨基酸/支链氨基酸比值显著下降 (均P<0.001)。Ⅲ期肝性脑病患者较无肝性脑病患者13种血清氨基酸浓度明显升高 (均P<0.05)。死亡者6种血清氨基酸浓度较好转者明显增高 (均P<0.05) ,尤以蛋氨酸为著。结论 慢性重型肝炎患者血清大部分必需和非必需氨基酸浓度均显著高于正常人。肝性脑病的程度与氨基酸浓度有正相关关系。血清蛋氨酸、酪氨酸浓度增高能间接反映肝细胞损害程度 ,且血清蛋氨酸值是反映肝细胞坏死程度的较好指标
Objective To detect the serum amino acid concentration in patients with chronic severe hepatitis and analyze the characteristics of its serum amino acid profile to provide a theoretical basis for clinical treatment of chronic severe hepatitis. Methods Serum amino acid concentrations of 50 patients with chronic severe hepatitis were determined by 4400 automatic amino acid analyzer and their amino acid profiles were analyzed. Results Serum levels of methionine, tyrosine and phenylalanine were significantly increased in patients with chronic severe hepatitis, and leucine, isoleucine, valine concentrations and aromatic amino acid / branched chain amino acid ratios were significantly decreased (all P <0.001). Serum levels of amino acids in 13 patients with stage III hepatic encephalopathy were significantly higher than those without hepatic encephalopathy (all P <0.05). Six death serum amino acid concentrations were better than those who improved significantly (all P <0.05), especially methionine. Conclusion The serum levels of most essential and non-essential amino acids in patients with chronic severe hepatitis are significantly higher than those in normal people. The degree of hepatic encephalopathy and amino acid concentration have a positive correlation. Serum methionine and tyrosine concentrations can indirectly reflect the extent of liver cell damage, and serum methionine value is a good indicator of the degree of hepatocyte necrosis