Lu Shu-liang, Ge Kui, Xie Ting, Jin Shu-wen, Shi Ji-xiang
Shanghai Burn Institute, Rui Jin Hospital Affiliated to Shanghai Second Medical University, Shanghai 200025, P.R. China.
Zhonghua Shao Shang Za Zhi. 2005 Aug;21(4):247-50.
To explore the influence of L-arginine supplementation on the plasma amino acid spectrum in burn patients.
Ten burn patients were randomly divided into burn control (n = 5, with compound 14 amino acid injection accounting for 2% of the total caloric value), and experimental (n = 5, with intravenous injection of L-arginine which accounted for 2% of total caloric value) groups. The intake of other nutrients for these two groups of patients was the same. The nutrient regimen was begun on the 3 PBD, with one quarter of the daily supply. On 4 and 5 PBD, one half of the daily supply was given, and from 6 to 21 PBD full supplementation was given. Venous blood samples were collected on 3, 7, 14, 21 and 28 PBD for the determination of plasma levels of amino acids. Ten normal volunteers served as normal control.
The plasma level of citrulline in both groups was significantly lower than normal value (P < 0.05) on 3 PBD before L-arginine supplementation. There was no obvious difference in plasma levels of ornithine and arginine in the two groups on 3 PBD compared with normal value (P > 0.05). The plasma level of ornithine, citrulline and arginine in burn control group declined on 3 PBD. The plasma level of arginine in experimental group on 14, 21 and 28 PBD were 280 +/- 121 micromol/L, 223 +/- 106 micromol/L and 110 +/- 44 micromol/L, respectively, which were significantly higher than those in burn control group (124 +/- 21 micromol/L, 59 +/- 15 micromol/L, 50 +/- 26 micromol/L). The plasma level of ornithine (30 +/- 5 micromol/L) and citrulline (162 +/- 44 micromol/L) on 21 PBD in experimental group were markedly higher than those in burn control group (8 +/- 7 micromol/L, 66 +/- 4 micromol/L, P < 0.05 or 0.01). There was no difference in the plasma levels of other amino acids at all postburn time points between the two groups (P > 0.05).
The production process of L-arginine from citrulline was accelerated after burns. The plasma levels of L-arginine, ornithine and citrulline were increased markedly after L-arginine supplementation, while that of other amino acids was not influenced. The pharmacological effects of L-arginine may be related to the promotion of ornithine cycle.
探讨补充L-精氨酸对烧伤患者血浆氨基酸谱的影响。
将10例烧伤患者随机分为烧伤对照组（n = 5，给予复方氨基酸14注射剂，占总热量的2%）和实验组（n = 5，静脉注射L-精氨酸，占总热量的2%）。两组患者其他营养素的摄入量相同。营养方案于伤后第3天开始，给予每日供应量的四分之一。在伤后第4天和第5天，给予每日供应量的一半，从伤后第6天至第21天给予全量补充。于伤后第3、7、14、21和28天采集静脉血样，测定血浆氨基酸水平。10名正常志愿者作为正常对照组。
补充L-精氨酸前，伤后第3天两组患者血浆瓜氨酸水平均显著低于正常值（P < 0.05）。伤后第3天，两组患者血浆鸟氨酸和精氨酸水平与正常值相比无明显差异（P > 0.05）。烧伤对照组伤后第3天血浆鸟氨酸、瓜氨酸和精氨酸水平下降。实验组伤后第14、21和28天血浆精氨酸水平分别为280±121μmol/L、223±106μmol/L和110±44μmol/L，显著高于烧伤对照组（124±21μmol/L、59±15μmol/L、50±26μmol/L）。实验组伤后第21天血浆鸟氨酸（30±5μmol/L）和瓜氨酸（162±44μmol/L）水平显著高于烧伤对照组（8±7μmol/L、66±4μmol/L，P < 0.05或0.01）。两组患者伤后各时间点其他氨基酸血浆水平无差异（P > 0.05）。
烧伤后瓜氨酸转化为L-精氨酸的过程加快。补充L-精氨酸后，血浆L-精氨酸、鸟氨酸和瓜氨酸水平显著升高，而其他氨基酸水平未受影响。L-精氨酸的药理作用可能与促进鸟氨酸循环有关。
