Pessi T, Koivula T, Kaukinene S, Marnela K M
Department of Surgery Tampere University Central Hospital, SF-33520 Tampere, Finland.
Clin Nutr. 1986 Nov;5(4):197-202. doi: 10.1016/0261-5614(86)90025-7.
Twenty-four patients with acute severe pancreatitis were randomised to receive total parenteral nutrition for 7 days with one of two isocaloric (35 kcal/kg/day) and isonitrogenous (0.16 g/kg/day) programmes containing either a low (15.5% w/w (control group)) or a high (57%) content of branched chain amino acids (BCAA (BCAA group)). During treatment, the nitrogen balance was similar in both groups. The concentrations of serum protein, albumin, prealbumin and retinol-binding protein did not differ between the groups. The plasma concentrations of BCAA measured 2 h after discontinuation of amino acid infusions rose in the BCAA group. In urine, only the concentrations of valine increased as compared with those of control patients. Serum glucose levels were higher in the BCAA group than in the control group, although the BCAA group received slightly more insulin than the control group in order to keep the blood glucose concentration below 10 mmol/l. The results suggest that BCAA-enriched solutions may stimulate gluconeogenesis without affecting catabolism.
24例急性重症胰腺炎患者被随机分为两组，分别接受为期7天的全胃肠外营养，两种等热量（35千卡/千克/天）、等氮量（0.16克/千克/天）的方案，其中一种方案的支链氨基酸（BCAA）含量低（15.5%重量/重量，对照组），另一种方案的BCAA含量高（57%，BCAA组）。治疗期间，两组的氮平衡相似。两组间血清蛋白、白蛋白、前白蛋白和视黄醇结合蛋白的浓度无差异。停止输注氨基酸2小时后测得的BCAA组血浆BCAA浓度升高。在尿液中，与对照组患者相比，只有缬氨酸浓度增加。BCAA组的血清葡萄糖水平高于对照组，尽管为了将血糖浓度维持在10毫摩尔/升以下，BCAA组接受的胰岛素略多于对照组。结果表明，富含BCAA的溶液可能会刺激糖异生，而不影响分解代谢。
