Lisander Björn, Lundvall Olle, Tomner Jens, Jones Alan W
Department of Anaesthesiology, University Hospital, 581 85 Linköping, Sweden.
Alcohol Alcohol. 2006 Jan-Feb;41(1):39-43. doi: 10.1093/alcalc/agh188. Epub 2005 Aug 8.
To investigate the effect of an amino acid mixture given intravenously (i.v.) on the rate of ethanol elimination from blood compared with equicaloric glucose and Ringer's acetate as control treatments.
In a randomized cross-over study, six healthy men (mean age 23 years) fasted overnight before receiving either Ringer's acetate, glucose or the amino acid mixture (Vamin 18 g N/l) by constant rate i.v. infusion over 4.5 h. Ethanol (0.4 g/kg) was given by an i.v. infusion lasting 60 min during the time each of the treatments was administered. At various times post-infusion, blood samples were taken for determination of ethanol by headspace gas chromatography. Blood glucose and heart rate were monitored at regular intervals. Concentration-time profiles of ethanol were plotted for each subject and the rate of ethanol disappearance from blood as well as other pharmacokinetic parameters were compared by repeated measures analysis of variance.
The rate of ethanol elimination from blood was increased significantly (P < 0.001) after treatment with amino acids (mean +/- SD, 0.174 +/- 0.011 g/l/h) compared with equicaloric glucose (0.121 +/- 0.016 g/l/h) or Ringer's acetate (0.110 +/- 0.013 g/l/h). Heart rate was also slightly higher during infusion of the amino acid mixture (P < 0.05).
When the rate of ethanol elimination from blood is relatively slow, such as after an overnight fast, it can be increased by approximately 60% after treatment with i.v. amino acids. The efficacy of amino acid treatment was not related to the supply of calories because glucose was no more effective than Ringer's acetate. We suggest that amino acids might increase hepatic oxygen consumption, resulting in a more effective conversion of NADH to NAD+ in mitochondria. An important feature of the experimental design was ensuring hepatic availability of amino acids during much of the time that ethanol was being metabolized.
研究静脉输注氨基酸混合物对血液中乙醇清除率的影响,并与等热量的葡萄糖和醋酸林格液作为对照处理进行比较。
在一项随机交叉研究中,六名健康男性(平均年龄23岁)隔夜禁食,然后通过4.5小时的恒速静脉输注接受醋酸林格液、葡萄糖或氨基酸混合物(凡命,18g氮/升)。在每种处理给药期间,通过持续60分钟的静脉输注给予乙醇(0.4g/kg)。输注后不同时间采集血样,采用顶空气相色谱法测定乙醇含量。定期监测血糖和心率。为每个受试者绘制乙醇的浓度-时间曲线,并通过重复测量方差分析比较血液中乙醇消失率以及其他药代动力学参数。
与等热量的葡萄糖(0.121±0.016g/升/小时)或醋酸林格液(0.110±0.013g/升/小时)相比,氨基酸处理后血液中乙醇清除率显著提高(P<0.001)(平均±标准差,0.174±0.011g/升/小时)。输注氨基酸混合物期间心率也略有升高(P<0.05)。
当血液中乙醇清除率相对较慢时,如隔夜禁食后,静脉输注氨基酸处理可使其提高约60%。氨基酸处理的效果与热量供应无关,因为葡萄糖并不比醋酸林格液更有效。我们认为氨基酸可能会增加肝脏的氧消耗,从而在线粒体中更有效地将NADH转化为NAD+。实验设计的一个重要特点是在乙醇代谢的大部分时间内确保肝脏能够获得氨基酸。