Takeda Y
First Department of Surgery, Chiba University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1991 Jul;92(7):785-93.
Validity of branched chain amino acid (BCAA) enriched solution in surgical stress was assessed using total catecholamine excretion (U-CA) as the severity in dex. Thirty percent BCAA solution was infused no 21 patients (T group), and 21% BCAA to 18 patients (P group) pre and postoperatively. 2.0 g protein and 35 kcal/kg.day were provided by total parenteral nutrition (TPN). Correlation of nitrogen-balance to U-CA was statistically significant in both groups (p less than 0.01). The difference of correlations was statistically significant when analyzed by covariance (p less than 0.05). Rapid turnover proteins were significantly higher in T group, but no difference of urinary 3-methylhistidine excretion was observed. Increased uptake of BCAA and release of glutamine and alanine by skeletal muscle were observed. However, no alteration in arterio-venous difference of phenylalanine and tyrosine was detected. In conclusion, 30% BCAA solution significantly improved postoperative protein metabolism, probably due to the improved visceral protein metabolism supported by amino acid supply by skeletal muscle.
使用总儿茶酚胺排泄量（尿儿茶酚胺，U-CA）作为应激程度指标，评估富含支链氨基酸（BCAA）溶液在手术应激中的有效性。对21例患者（T组）术前和术后输注30%的BCAA溶液，对18例患者（P组）术前和术后输注21%的BCAA溶液。通过全胃肠外营养（TPN）提供2.0 g蛋白质和35 kcal/kg·天的能量。两组中氮平衡与U-CA的相关性均具有统计学意义（p<0.01）。经协方差分析，相关性差异具有统计学意义（p<0.05）。T组快速周转蛋白显著更高，但尿3-甲基组氨酸排泄量无差异。观察到骨骼肌对BCAA的摄取增加以及谷氨酰胺和丙氨酸的释放增加。然而，未检测到苯丙氨酸和酪氨酸的动静脉差值有变化。总之，30%的BCAA溶液显著改善了术后蛋白质代谢，这可能是由于骨骼肌提供的氨基酸支持了内脏蛋白质代谢的改善。
