Takala J, Klossner J
Department of Anesthesiology, Turku University Central Hospital, SF-20520 Turku, Finland.
Clin Nutr. 1986 Aug;5(3):167-70. doi: 10.1016/0261-5614(86)90006-3.
The metabolic responses to branched chain amino acid enriched total parenteral nutrition were studied in surgical intensive care patients with documented severe catabolism. Twenty-four patients were randomised to receive total parenteral nutrition with either 50% (BCAA) or 15% (CONTROL) of its amino acid content as branched chain amino acids. The daily intake of nitrogen was 0.24 g per kg b. wt and that of energy, at steady state, 45 kcal per kg b. wt. Total parenteral nutrition resulted in similar nitrogen balances (Day 1 BCAA: -0.07 +/- 0.09, CONTROL: -0.05 +/- 0.10; Day 4 BCAA: -0.12 +/- 0.07, CONTROL: -0.06 +/- 0.09; Day 5 BCAA: -0.07 +/- 0.08, CONTROL: -0.05 +/- 0.08 g/kg b. wt day; mean +/- S.D.) in both treatment groups throughout the study. The urinary excretion of 3-methylhistidine was higher before feeding in the control group but the rates were similar during total parenteral nutrition in both groups. There were no differences between the groups in the decrease of serum prealbumin during the study. We conclude that the proposed benefits, if any, from enriching nutritional regimens with branched chain amino acids are unlikely to be of major therapeutic relevance in severe catabolism.
在有严重分解代谢记录的外科重症监护患者中，研究了富含支链氨基酸的全胃肠外营养的代谢反应。24名患者被随机分配接受全胃肠外营养，其氨基酸含量的50%（支链氨基酸组）或15%（对照组）为支链氨基酸。氮的每日摄入量为每千克体重0.24克，在稳定状态下能量的每日摄入量为每千克体重45千卡。在整个研究过程中，两个治疗组的全胃肠外营养导致的氮平衡相似（第1天：支链氨基酸组：-0.07±0.09，对照组：-0.05±0.10；第4天：支链氨基酸组：-0.12±0.07，对照组：-0.06±0.09；第5天：支链氨基酸组：-0.07±0.08，对照组：-0.05±0.08克/千克体重·天；均值±标准差）。对照组在进食前3-甲基组氨酸的尿排泄量较高，但两组在全胃肠外营养期间的排泄率相似。在研究期间，两组血清前白蛋白的下降没有差异。我们得出结论，在严重分解代谢中，用支链氨基酸丰富营养方案所带来的任何益处（如果有的话）不太可能具有主要的治疗相关性。
