高支链氨基酸在肝移植术后病人肠外营养中的应用  

The use of enriched branch chain amino acid in the parenteral nutrition of patients after liver transplantation

作　　者：鱼晓波[1] 夏强[1] 张建军[1] 陈小松[1] 张明[1] 罗毅[1] 沈从欢[1] 邢天宇[1] 

机构地区：[1]上海交通大学医学院附属仁济医院器官移植中心,上海200127

出　　处：《肠外与肠内营养》2007年第1期35-38,共4页Parenteral & Enteral Nutrition

摘　　要：目的:评价肝移植术后病人以高支链氨基酸为氮源的静脉营养支持效果。方法:选择肝移植术后进行1周肠外营养支持(PN)的病人20例,随机分为高支链氨基酸组和平衡氨基酸组,每组各10例。两组营养支持均等热量、等氮量,分别于术后第1、8天检测营养状态指标。营养支持期间,每天测定氮,并计算累计氮平衡。结果:①两组病人体重、总蛋白、丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、结合胆红素等肝功能指标均恢复较好。②术后第8天高支链氨基酸组血清清蛋白水平显著高于平衡氨基酸组(P<0.05)。③术后第3天起,高支链氨基酸组氮平衡明显优于平衡氨基酸组(P<0.05)。术后7 d累计氮平衡高支链氨基酸组明显优于平衡氨基酸组(P<0.01)。结论:①肝移植术后采用高支链氨基酸作为氮源的静脉营养支持安全、有效。②高支链氨基酸的节氮效果优于平衡氨基酸。Objective： To evaluate efficiency of the formula of enriched branch chain amino acid （BCAA） on parenteral nutrition support in patients after liver transplantation. Methods：A randomized controlled clinical trial was conducted comparing the role of Aminoplasmal Hepa with Novamin in 20 patients. The intake was isonitrogenic and isocalorie in the two groups. Nutrition state test before and the 1 th and 8th day after operation were analysed. Nitrogen balance was measured daily. Results：（1） Liver function indicators of two groups restored well. （2） The concentration of serum albumin in the group of Aminoplasmal Hepa was higher than that in the Novamin group （P 〈 0.05 ）. （3）Nitrogen balance was superior in BCAA group to Novamin group （P 〈 0.05 ）. Conclusion： （1） Parenteral nutrition of Aminoplasmal Hepa is safe and effective in the patients after liver transplantation. （2）Enriched BCAA support is superior to general amino acids support in improving nitrogen balance.

关 键 词：高支链氨基酸 肠外营养 肝移植 

分 类 号：R657.3[医药卫生—外科学] R459.3[医药卫生—临床医学]