创伤患者的节氮与氨基酸谱正常化作用——个体化氨基酸代谢支持的研究

本文以45例行根治性全胃切除术的病例为临床创伤模型,前瞻地研究了不同氮源的代谢支持对血清与肌肉细胞内氨基酸谱的影响,以及观察了体重和氮平衡的变化.结果发现,根据患者血清各个氨基酸的变化,调整其含量组成,匹配较为合理的个体化氟基酸混合液有较多的优点:1.显著地改善了氮平衡,减少术后体重下降.2.可降低创伤后肌肉细胞内增高的苯丙氨酸值.3.由于补充了较多的生糖氨基酸,使血清和肌肉细胞内的生糖氨基酸维持在正常范围。4.能升高血清和肌肉细胞内精氨酸和鸟氨酸的含量.这些结果,均有利于机体创伤后氨基酸谱的正常化与早日恢复.

The role of individualized amino acids metabolic support on nitrogen sparing and normalization of amino acids pattern in surgical trauma patients

The effects of metabolic support with different amino acid solutions on serum and muscle amino acid levels,nitrogen balance and body weight loss in 45 gastric cancer patients underwent total,gastrectomy were studied prospectively.The results showed that the benefits to the patients received individual amino acids infusion (IDAA) are quite obvious.The con- tent of amino acids in IDAA is calculated individually according to the se- rum levels on the 4th postoperation day and is different in each patients.The metabolic support with IDAA can (1)improves nitrogen efficiency,reduces the body weight loss;(2)decreases the muscle intracellular phenylalanine level;(3)increases the levels of free neoglucogenic amino acids,argining and ornithine both in serum and muscle cells.All of the findings beneficial for the patient's early recovery from trauma and normalization of serum and/ or muscle amino acids pattern.