恶性血液病化疗患者血浆氨基酸动态监测及临床意义  

DYNAMIC MONITORING OF PLASMA AMINO ACIDS IN CHEMOTHERAPY OF PATIENTS WITH HEMATOLOGICAL MALIGNANCIES AND ITS CLINICAL VALUE

作　　者：关阳[1,2] 黄雅静[3] 李惠子 刘丽宏[4] 吕利[5] 糜漫天[1] 

机构地区：[1]第三军医大学营养与食品卫生学教研室,重庆400038 [2]第二炮兵总医院营养科,北京100088 [3]第二炮兵总医院血液科,北京100088 [4]第二炮兵总医院药剂科,北京100088 [5]北京武警总医院营养科,北京100039

出　　处：《营养学报》2013年第6期549-553,共5页Acta Nutrimenta Sinica

摘　　要：目的观察血液病强化化疗患者30种血浆氨基酸代谢的变化特点。方法选择血液病强化化疗患者23例,在化疗前、化疗后1 d、化疗后8d及化疗后14d四个时间点,采集血液,用高效液相色谱-串联质谱的方式定量检测30种氨基酸含量,同时检测30例健康人30种氨基酸水平作为正常对照值。结果与健康对照组比较,血液病患者血浆氨基酸浓度在骨髓抑制期(化疗后1d和化疗后8d)与造血恢复期(化疗后14d)Asp、Glu、Met、Val、Tyr、Phe、Orn、Lys、Arg、Pro显著升高(P<0.05);Tau、Asn、Gln、Gly、Ala、Cys、Ile、His、Trp以及BCAA/AAA(支/芳)显著下降(P<0.05)。结论动态监测血液病患者强化化疗前后30种血浆氨基酸谱的变化,可以反映机体代谢及营养状况,对血液病患者进行营养治疗和营养支持有一定参考和指导意义.Objective To observe plasma amino acid characteristics in patients with malignant hematological diseases during chemotherapy. Methods The blood samples of 23 patients with hematological malignancies were collected at four time points, i.e. before chemotherapy, at transplantation period （＋ld）, bone marrow depression period （＋Sd） and hernatopoietic recovery period（＋14d）. Thirty plasma amino acids were determined by high-performance liquid chromatography-tandem mass spectrometry method, Simultaneously 30 amino acid levels were detected in 30 healthy individuals as normal control. Results Compared to healthy people in the control group, plasma amino acid concentrations of Asp, Glu, Met, Val, Tyr, Phe, Orn, Lys, Arg, Pro were increased significantly （P〈0.05）; in the patients during chemotherapy and hematopoietic recovery period, and Tau, Asn, Gln, Gly, Ala, Cys, Ile, His, Trp, BCAA/ AAA （support / aryl） were decreased significantly （P〈0.05）.Conclusion Real time monitoring of plasma amino acids in patients with malignant blood diseases can directly reflect the body＇s metabolism and nutritional status. The results provide a reference for nutrition therapy or support for patients with hematologic malignancies. [ACTA NUTRIMENTA SINICA, 2013,35（6）： 549-553]

关 键 词：血浆氨基酸 血液病 强化化疗 高效液相色谱-串联质谱 

分 类 号：R552[医药卫生—血液循环系统疾病]