The effect of normalization of plasma amino acids on hepatic encephalopathy in man.

摘要: Previous work from this laboratory has suggested that the plasma amino acid pattern, known to be deranged in hepatic encephalopathy, may related causally. In order test hypothesis, 23% dextrose and a special solution whose components were calculated normalize pattern infused 11 patients, eight with chronic cirrhosis acute exacerbation (Group 1) three patients fulminant hepatitis 2), amounts of up 120 Gm. protein equivalent per 24 hours. Plasma acids abnormal but different both groups. Group 1 (cirrhosis) changes including elevated phenylalanine, tyrosine, glutamate, aspartate, methionine decreased valine, leucine, isoleucine. 2 all elevated, exception branched chains which normal. Hepatic encephalopathy improved one following infusion. The ratio (see article) showed an excellent correlation grade encephalopathy. When ratio, previously 1.0 presence returned normal value near 3.0 3.5, improved. An was obtained between dose as well. results suggest patterns differing etiologies require treatment modalities differ for two types Whereas infusion appears valuable, efficacious way providing nutrition treating deterioration coma, other means therapy such plasms "laundering" appear necessary hepatitis.