Vesali Rokhsareh F, Klaude Maria, Rooyackers Olav, Wernerman Jan
Department of Anesthesiology & Intensive Care, Karolinska Institutet, KFC Novum, Karolinska University Hospital, S-141 86 Huddinge, Sweden.
Am J Physiol Endocrinol Metab. 2005 Feb;288(2):E360-4. doi: 10.1152/ajpendo.00248.2004. Epub 2004 Sep 14.
Decreased plasma amino acid concentrations and increased net release of amino acids from skeletal muscle, especially for glutamine, are common features in critically ill patients. A low dose of endotoxin administered to healthy volunteers was used as a human model for the initial phase of sepsis to study the early metabolic response to sepsis. Six healthy male volunteers were studied in the postabsorptive state. Blood samples from the forearm artery and femoral vein were taken during 4 h before and 4 h after an intravenous endotoxin injection (4 ng/kg body wt). In addition, muscle biopsies from the leg muscle were taken. Plasma concentration of the total sum of amino acids decreased by 19% (P = 0.001) and of glutamine by 25% (P = 0.004) the 3rd h after endotoxin administration. At the same time, muscle concentrations of the sum of amino acids and glutamine decreased by 11% (P = 0.05) and 9% (P = 0.09), respectively. In parallel, the efflux from the leg increased by 35% (P = 0.004) for the total sum of amino acids and by 43% (P = 0.05) for glutamine. In conclusion, intravenous endotoxin administration to healthy volunteers, used as a model for the initial phase of sepsis, resulted in a decrease in plasma amino acid concentrations. At the same time, amino acid concentrations in muscle tissue decreased, whereas the efflux of amino acids from leg skeletal muscle increased.
血浆氨基酸浓度降低以及骨骼肌氨基酸净释放增加,尤其是谷氨酰胺,是危重症患者的常见特征。给健康志愿者注射低剂量内毒素作为脓毒症初始阶段的人体模型,以研究对脓毒症的早期代谢反应。对6名处于空腹状态的健康男性志愿者进行了研究。在静脉注射内毒素(4 ng/kg体重)前4小时和后4小时采集前臂动脉和股静脉血样。此外,还采集了腿部肌肉活检样本。内毒素给药后第3小时,血浆总氨基酸浓度下降了19%(P = 0.001),谷氨酰胺浓度下降了25%(P = 0.004)。与此同时,肌肉中氨基酸总量和谷氨酰胺浓度分别下降了11%(P = 0.05)和9%(P = 0.09)。同时,腿部氨基酸总流出量增加了35%(P = 0.004),谷氨酰胺增加了43%(P = 0.05)。总之,给健康志愿者静脉注射内毒素作为脓毒症初始阶段的模型,导致血浆氨基酸浓度降低。与此同时,肌肉组织中的氨基酸浓度降低,而腿部骨骼肌的氨基酸流出量增加。