肝昏迷患者的血浆游离色氨酸含量比肝硬化或无肝疾病者为高,同时脑脊液(CSF)中色氨酸Try)亦增加。如果Try代谢异常与肝昏迷患者中枢神经系统的变化有关,那就应当在中枢神经系统中见到伴随这些变化的异常代谢。过去,相互对比研究(Cross-sectional Study)发现,肝昏迷伴有血浆游离Try含量升高。要更确切地证实生化异常与肝昏迷之间的关系,必须对中枢神经功能改变的病人,持续地观察生化方面的变化。本文报导6例患者,在从昏迷至苏醒的不同临床阶段,测定Try及影响其进入脑组织的物质的含量变化。选定肝硬化伴有Ⅲ-IV期肝昏迷且随后苏醒的患者6例,无肝疾患的其 Patients with hepatic coma had higher free tryptophan plasma levels than those with cirrhosis or liver disease, and tryptophan Try in cerebrospinal fluid (CSF) also increased. If abnormal Try metabolism is associated with central nervous system changes in patients with hepatic coma, abnormal metabolism with these changes should be seen in the central nervous system. In the past, the cross-sectional study found that hepatic coma with elevated plasma free Try levels. To more accurately confirm the relationship between biochemical abnormalities and hepatic coma, changes in biochemistry must be continually observed in patients with altered central nervous function. In this paper, we report six cases of Try and the changes in the levels of substances that affect their entry into the brain at different clinical stages from coma to recuperation. Six patients with cirrhosis with stage III-IV hepatic coma and subsequent wake-up were selected, and those with no liver disease