Cao W X
Rinjin Hospital, Shanghai Second Medical University.
Zhonghua Wai Ke Za Zhi. 1990 Dec;28(12):742-4, 782-3.
In this study, the changes of protein kinetics in patients with gastric cancer were determined using by 15N-glycine tracer assay before and after parenteral nutrition. The results showed that the protein turnover especially anabolic rate may be enhanced by parenteral nutritional support. The pre- and post operative increase of protein anabolic rate was more than that of the catabolic rate, about 10% and 88% respectively. This phenomenon could be explained as following, (1). the abnormal metabolism in cancer patients was extinguished after the tumor resection; (2). the supplementation of the nitrogen was increased; (3). branched chain amino acids could be used as energy resource for muscle metabolism and to improve protein synthesis while its breakdown was inhibited.
It is necessary to administer the parenteral nutritional support to patients with malnutrition before operation. With adequate nitrogen and calorie supply, negative nitrogen balance could be improved.
在本研究中,通过15N-甘氨酸示踪分析测定了胃癌患者在肠外营养前后蛋白质动力学的变化。结果表明,肠外营养支持可能会提高蛋白质周转率,尤其是合成代谢率。术前和术后蛋白质合成代谢率的增加均超过分解代谢率,分别约为10%和88%。这种现象可以如下解释:(1)肿瘤切除后癌症患者的异常代谢消失;(2)氮补充增加;(3)支链氨基酸可作为肌肉代谢的能量来源并促进蛋白质合成,同时其分解受到抑制。
术前对营养不良的患者给予肠外营养支持是必要的。通过充足的氮和热量供应,可以改善负氮平衡。