目的　探讨精氨酰琥珀酸尿症致反复高氨血症的诊断和治疗。方法　回顾分析1例精氨酰琥珀酸尿症 患儿的诊治及随访经过，并复习相关文献。结果　患儿，男，13个月，因呕吐、嗜睡、反应差入院，检查发现血氨升高 （138.02 μmol/L），肝功能异常，伴低钾血症，血瓜氨酸升高（65.64 μmol/L）；脑电图异常。完善高氨血症相关基因的二 代基因测序，发现精氨酰琥珀酸裂解酶基因（ASL）复合杂合突变。予以限制蛋白饮食、补充精氨酸治疗，患儿高氨血症仍 反复发作，肝脏进行性增大；确诊1年后行肝移植。移植后1年，患儿肝功能、血氨无异常，生长发育无异常。结论　精氨 酰琥珀酸尿症临床表现复杂，高氨血症是其重要表现；基因检查有助确诊，肝移植治疗有效。

　Objective　To explore the diagnosis and treatment of recurrent hyperammonemia caused by argininosuccinic aciduria. Method　The diagnosis, treatment and follow-up of argininosuccinic aciduria in a child were retrospectively analyzed, and the related literature was reviewed. Results　A 13-month-old boy was admitted to hospital for vomiting, sleepiness and poor reaction. The results showed elevated blood ammonia (138.02 μmol/L), abnormal liver function, hypokalemia, elevated blood citrulline (65.64 Umol/L), and abnormal electroencephalogram. The second generation gene sequencing was performed on hyperammonia-related genes, and the compound heterozygous mutation of argininosuccinate lyase (ASL) gene was found. After the treatment with protein restriction diet and arginine supplementation, the children's hyperammonia still recurred and the liver was progressively enlarged. One year after the diagnosis, liver transplantation was performed. At present, 1 year after transplantation, the liver function, blood ammonia, growth and development of the child were normal. Conclusion　The clinical manifestations of argininosuccinic aciduria are complex, and hyperammonia is an important manifestation. Gene examination is helpful for diagnosis and liver transplantation is effective.