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[儿童糖尿病酮症酸中毒患者血液及尿液氨基酸浓度的随访]

[Follow-up of blood and urinary amino acid concentrations in diabetic ketoacidosis in children].

作者信息

Szabó A, Kenesei E, Miltényi M, Körner A, Szücs L, Nagy I

机构信息

Semmelweis Orvostudományi Egyetem, I. sz. Gyermekklinika, Budapest.

出版信息

Orv Hetil. 1990 Mar 25;131(12):615-9.

PMID:2108399
Abstract

Plasma and urinary concentrations of amino acids were investigated during diabetic ketoacidosis (DKA) and 12, 24, 72 hours after initiation of therapy. In DKA plasma concentration of glutamic acid, asparaginic acid, valine, leucine and isoleucine significantly increased while that of asparagine and glutamine decreased compared to levels in well controlled diabetic patients. Despite the elevated urinary excretion of branched chain amino acids, histidine, serine and threonine, urinary excretion and clearance of glutamic acid, glutamine, glycine and taurine were reduced. Among the different amino acids histidine excretion had the highest variability. Strong correlation was found between the urinary excretion of several amino acids and that of the beta-2-microglobulin characterizing tubular dysfunction. Changes in the excretion of different amino acids reflect the altered metabolic state and renal function due to diabetic ketoacidosis.

摘要

在糖尿病酮症酸中毒(DKA)期间以及治疗开始后的12、24、72小时,对血浆和尿液中的氨基酸浓度进行了研究。与血糖控制良好的糖尿病患者相比,在DKA中,谷氨酸、天冬氨酸、缬氨酸、亮氨酸和异亮氨酸的血浆浓度显著升高,而天冬酰胺和谷氨酰胺的血浆浓度降低。尽管支链氨基酸、组氨酸、丝氨酸和苏氨酸的尿排泄增加,但谷氨酸、谷氨酰胺、甘氨酸和牛磺酸的尿排泄和清除减少。在不同氨基酸中,组氨酸排泄的变异性最高。发现几种氨基酸的尿排泄与表征肾小管功能障碍的β-2-微球蛋白的尿排泄之间存在强相关性。不同氨基酸排泄的变化反映了糖尿病酮症酸中毒导致的代谢状态和肾功能改变。

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