Roth E, Funovics J, Mühlbacher F, Schemper M, Mauritz W, Sporn P, Fritsch A
Department of Surgery and Intensive Care Unit I, Dept. of Anesthesiology and General Intensivmedicine, University of Vienna, Medical School Austria.
Clin Nutr. 1982 Mar;1(1):25-41. doi: 10.1016/0261-5614(82)90004-8.
The metabolic profiles of 14 patients with prolonged abdominal sepsis were analysed on the second day after laparotomy. The profiles of survivors were compared with those of non-survivors who died one to five days after the time of evaluation due to uncontrollable multiple organ failure. In the non-surviving patients plasma glucose and glucagon levels were significantly higher than in surviving patients. The plasma concentrations of phosphoserine, cysteine, valine, phenylalanine, and 3-methylhistidine were found to be significantly increased in non-survivors and their muscle tissue showed significantly decreased concentrations of glutamine, proline and lysine with increases in valine and leucine. A correct classification of non-survivors and survivors could be obtained from the plasma and muscle amino acid concentrations, the highest discriminant power being from muscle glutamine. In severe sepsis metabolic changes correlate with the outcome of the patients, and amino acid metabolism seems to be characterised by low concentrations of muscle glutamine and high levels of the branched chain amino acids possibly indicating an inhibited intracellular glutamine formation in muscle tissue.
在剖腹手术后第二天，对14例腹部脓毒症持续时间较长的患者的代谢谱进行了分析。将幸存者的代谢谱与因无法控制的多器官衰竭在评估时间后1至5天死亡的非幸存者的代谢谱进行了比较。在非存活患者中，血浆葡萄糖和胰高血糖素水平显著高于存活患者。发现非幸存者血浆中磷酸丝氨酸、半胱氨酸、缬氨酸、苯丙氨酸和3-甲基组氨酸的浓度显著升高，其肌肉组织中谷氨酰胺、脯氨酸和赖氨酸的浓度显著降低，缬氨酸和亮氨酸增加。从血浆和肌肉氨基酸浓度可以正确区分非幸存者和幸存者，肌肉谷氨酰胺的判别能力最强。在严重脓毒症中，代谢变化与患者的预后相关，氨基酸代谢的特征似乎是肌肉谷氨酰胺浓度低和支链氨基酸水平高，这可能表明肌肉组织中细胞内谷氨酰胺形成受到抑制。
