Brown R O, Buonpane E A, Vehe K L, Hickerson W L, Luther R W
Department of Clinical Pharmacy, University of Tennessee, Memphis.
Crit Care Med. 1990 Oct;18(10):1096-101. doi: 10.1097/00003246-199010000-00009.
Twenty thermally injured patients who could not tolerate enteral nutrition support were randomized to receive parenteral nutrition (PN) with either modified amino acids (MAA) or standard amino acids (SAA). There was no significant difference between groups for age, sex, weight, percent BSA area burn, percent third-degree burn, or operative procedures. N balance (NB) was measured and serum was harvested for circulating fibronectin (Fn), somatomedin-C/insulin-like growth Factor I (Sm-C), prealbumin (PA), and retinol-binding protein (RBP) analysis on days 1, 4, 7, 14, 21, and 28 of PN. The patient groups received similar doses of PN for a similar number of days. Fn did not change significantly from baseline in either group and there was no significant difference between groups. Sm-C increased significantly from baseline at day 7 in the SAA group and in both groups on day 14, but there was no significant difference between groups. PA and RBP increased significantly from baseline on day 7 in the MAA group and in both groups on days 14, 21, and 28. RBP was significantly higher in the MAA group only on day 21, and there was no significant difference between groups for PA. NB increased significantly from baseline for all study days; however, there was no significant difference between groups. PN in thermally injured patients significantly improves NB and increases visceral protein concentrations. However, there appears to be no difference between PN with MAA or SAA.
20名无法耐受肠内营养支持的热烧伤患者被随机分为两组，分别接受含改良氨基酸（MAA）或标准氨基酸（SAA）的肠外营养（PN）。两组在年龄、性别、体重、烧伤面积百分比、三度烧伤百分比或手术操作方面无显著差异。在PN治疗的第1、4、7、14、21和28天测量氮平衡（NB），并采集血清用于循环纤维连接蛋白（Fn）、生长调节素-C/胰岛素样生长因子I（Sm-C）、前白蛋白（PA）和视黄醇结合蛋白（RBP）分析。两组患者接受相似剂量的PN，治疗天数相似。两组中Fn均未较基线有显著变化，且两组间无显著差异。SAA组在第7天、两组在第14天Sm-C较基线显著增加，但两组间无显著差异。MAA组在第7天、两组在第14、21和28天PA和RBP较基线显著增加。仅在第21天MAA组的RBP显著更高，两组间PA无显著差异。在所有研究日NB均较基线显著增加；然而，两组间无显著差异。热烧伤患者的PN显著改善NB并增加内脏蛋白浓度。然而，含MAA或SAA的PN之间似乎没有差异。
