Holroyde C P, Myers R N, Smink R D, Putnam R C, Paul P, Reichard G A
Cancer Res. 1977 Sep;37(9):3109-14.
In order to evaluate the metabolic response of nutritionally deprived cancer patients to parenteral nutrition, metabolic parameters including glucose turnover, oxidation, and Cori cycle activity were measured in eight patients before and during short-term (5 to 10 days) i.v. nutrition, with solutions containing amino acids and hypertonic glucose. Before parenteral nutrition, five patients had essentially normal glucose turnover, oxidation, and Cori cycle activity, whereas three patients had moderately increased glucose turnover and markedly increased Cori cycle activity. In response to parenteral nutrition, plasma glucose, insulin, and venous lactate concentration increased and free fatty acid decreased. The percentage of respiratory CO2 from glucose oxidation and the rate of oxidation increased. CO2 production increased, whereas O2 consumption was essentially unchanged. Respiratory quotient rose to greater than 1.0. Endogenous glucose production and high basal Cori cycle activity were decreased. Total parenteral nutrition was judged clinically beneficial in five patients, whereas one patient was unchanged. Deleterious responses, including moderate lactic acidemia, occurred in two of three patients with elevated basal Cori cycle activity.
为了评估营养缺乏的癌症患者对肠外营养的代谢反应，在8例患者短期（5至10天）静脉内营养期间及之前，测量了包括葡萄糖周转率、氧化和科里循环活性在内的代谢参数，所用溶液含有氨基酸和高渗葡萄糖。在肠外营养之前，5例患者的葡萄糖周转率、氧化和科里循环活性基本正常，而3例患者的葡萄糖周转率中度增加，科里循环活性显著增加。对肠外营养的反应是，血浆葡萄糖、胰岛素和静脉乳酸浓度增加，游离脂肪酸减少。葡萄糖氧化产生的呼吸性二氧化碳百分比和氧化速率增加。二氧化碳产生增加，而氧气消耗基本不变。呼吸商升至大于1.0。内源性葡萄糖生成和高基础科里循环活性降低。临床判断全肠外营养对5例患者有益，而1例患者无变化。在基础科里循环活性升高的3例患者中，有2例出现了包括中度乳酸血症在内的有害反应。
