静脉输注氨基酸对严重创伤病人血氨基酸谱和氮平衡的影响  

Effect of amino acid infusion on free amino acid spectrum in plasma and nitrogen balance in severe trauma patients

作　　者：骆建军[1] 施建国[1] 方雪玲[2] 方强[2] 傅素珍[3] 姚远[1] 

机构地区：[1]解放军第117医院ICU,浙江杭州310004 [2]浙江大学医学院附属第一医院ICU,浙江杭州310006 [3]浙江大学医学院附属第一医院感染科实验室,浙江杭州310006

出　　处：《肠外与肠内营养》2011年第1期6-8,共3页Parenteral & Enteral Nutrition

基　　金：全军医药卫生科研攻关基金项目(08G097)

摘　　要：目的:探讨严重创伤病人静脉输注复方氨基酸对血游离氨基酸谱和氮平衡的的影响。方法:将40例严重创伤病人随机分为试验组(输注氨基酸+葡萄糖+脂肪乳剂)和对照组(输注葡萄糖+脂肪乳剂)。4 d后测定血游离氨基酸谱和氮平衡。结果:对照组病人大部分氨基酸(甘氨酸、半胱氨酸、缬氨酸、蛋氨酸、异亮氨酸、亮氨酸、赖氨酸、组氨酸、精氨酸)显著低于试验组(P<0.05);两组苯丙氨酸/酪氨酸(Phe/Tyr)比值显著高于正常值(P<0.05);支链氨基酸/芳香族氨基酸(BCAA/AAA)比值显著低于正常值(P<0.05);试验组病人与对照组比,氮平衡得到明显改善(P<0.05)。结论:严重创伤后病人给予静脉输注1.2 g/(kg.d)氨基酸,可提高血中大部分游离氨基酸的水平,改善氮平衡,但未改善氨基酸代谢障碍。Objective： To investigate the effect of amino acid infusion on free amino acid spectrum in plasma and nitrogen balance in severe trauma patients.Methods： 40 severe trauma patients were randomly divided into two groups： experiment group（amino acid＋glucose＋fat emulsion） and control group（glucose＋fat emulsion）.Blood samples were taken for determination of plasma levels of free amino acid and nitrogen balancewas was measured after 4 days.Results： The levels of glycine,cysteine,valine,methionine,isoleucine,leucine,lysine,histidine and arginine in experiment group were significantly higher than those in control group（P0.05）.The ratio of phenylalanine and tyrosine（Phe/Tyr）and the ratio of branched-chain amino acids and aromatic amino acids（BCAA/AAA）in two groups were not different and clearly higher or lower than the normal value（P0.05）.The nitrogen balance was-（6.6±3.8）g/L in control group and -（0.7±5.0）g/L in experiment group（P0.05）.Conclusion： Intravenous infusion of 1.2 g/（kg·d）amino acid can increase the levels of most of free amino acid in severe trauma patients.Supplement of amino acid can improve nitrogen balance,but can not correct the amino acid metabolism disorder.

关 键 词：严重创伤 氨基酸谱 氮平衡 

分 类 号：R641[医药卫生—外科学]