Wang Xin-Ying, Li Ning, Gu Jun, Li Wei-Qin, Li Jie-Shou
Medical School of Nanjing University, Research Institute of General Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China.
World J Gastroenterol. 2003 Mar;9(3):599-602. doi: 10.3748/wjg.v9.i3.599.
To investigate the formula of amino acid enriched BCAA on nutritional support in traumatic patients after operation.
40 adult patients after moderate or large abdominal operations were enrolled in a prospective, randomly and single-blind-controlled study, and received total parenteral nutrition (TPN) with either formula of amino acid (AA group, 20 cases) or formula of amino acid enriched BCAA (BCAA group, 20 cases). From the second day after operation, total parenteral nutrition was infused to the patients in both groups with equal calorie and equal nitrogen by central or peripheral vein during more than 12 hours per day for 6 days. Meanwhile, nitrogen balance was assayed by collecting 24 hours urine for 6 days. The markers of protein metabolism were investigated such as amino acid patterns, levels of total protein, albumin, prealbumin, transferrin and fibronectin in serum.
The positive nitrogen balance in BCAA group occurred two days earlier than that in AA group. The serum levels of total protein and albumin in BCAA group were increased more obviously than that in AA group. The concentration of valine was notably increased and the concentration of arginine was markedly decreased in BCAA group after the formula of amino acids enriched BCAA transfusion.
The formula of amino acid enriched BCAA may normalize the levels of serum amino acids, reduce the proteolysis, increase the synthesis of protein, improve the nutritional status of traumatic patients after operation.
探讨富含支链氨基酸（BCAA）的氨基酸配方对创伤患者术后营养支持的作用。
40例中、大型腹部手术后成年患者纳入一项前瞻性、随机、单盲对照研究，分别接受氨基酸配方（氨基酸组，20例）或富含BCAA的氨基酸配方（BCAA组，20例）的全胃肠外营养（TPN）。术后第2天起，两组患者均通过中心静脉或外周静脉每天输注超过12小时的等热量、等氮量全胃肠外营养，共6天。同时，连续6天收集24小时尿液测定氮平衡。检测血清氨基酸谱、总蛋白、白蛋白、前白蛋白、转铁蛋白和纤维连接蛋白等蛋白质代谢指标。
BCAA组的正氮平衡比氨基酸组提前2天出现。BCAA组血清总蛋白和白蛋白水平升高比氨基酸组更明显。输注富含BCAA的氨基酸配方后，BCAA组缬氨酸浓度显著升高，精氨酸浓度明显降低。
富含BCAA的氨基酸配方可使血清氨基酸水平正常化，减少蛋白质分解，增加蛋白质合成，改善创伤患者术后营养状况。
