摘要
目的 探讨严重肝病患者血氨和血清色氨酸测定的临床意义。方法 采用分光光度法测定严重肝病患者 56例 (重型肝炎 32例、失代偿肝硬化 17例、原发性肝癌 7例 )和一般慢性肝炎患者 4 9例的血氨及血清色氨酸含量。结果 慢性肝炎患者血氨及血清游离色氨酸正常 ,而严重肝病患者则显著增高。肝性脑病患者血氨、血清游离色氨酸均显著高于无肝性脑病患者。随着病情进展 ,严重肝病患者血氨在中、晚期显著高于恢复期 ,晚期又显著高于中期 ;血清游离色氨酸晚期显著高于恢复期和中期 ,但中期与恢复期相比差异无显著性。结论 血氨增高和色氨酸代谢紊乱在肝性脑病发病机理中起着重要的作用。
Objective:To investigate the clinical value of blood ammonia and serum tryptophan from patients with severe liver diseases.Method:Blood ammonia and serum tryptophan from 56 patients with severe liver diseases (32 with severe hepatitis,17 with decompensate cirrhosis and 7 with primary hepatic carcinoma)and 49 patients with chronic hepatitis were determined by spectrophotometry.Results:The contents of blood ammonia and serum tryptophan in chronic hepatitis patients were in the normal range but significantly increased in patients with severe hepatitis or decompensate cirrhosis or primary hepatic carcinoma.It also significantly increased in patients with hepatic encephalopathy compared to the non-hepatic encephalopathy.With the aggravation of severe hepatitis,the contents of blood ammonia and serum free tryptophan tended to be obviously increased.Conclusions: Both high level of blood ammonia and decompensation of tryptophan may play an important role in the hepatic encephalopathy.It has great clinical significance to detect blood ammonia dynamically for prognosis and treatment of severe hepatitis patients.
基金
湖南省科委及衡阳市科委基金资助项目
关键词
血氨
色氨酸
肝病
测定
blood
ammonia
tryptophan
liver disease
