Department of Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:123-30. doi: 10.1111/jgh.12405.
The response to critical illness involves alterations in all aspects of metabolic control, favoring catabolism of body protein. In particular, body protein loss occurring as a result of the alteration of protein metabolism has been reported to be inversely correlated with the survival of critically ill patients. Despite the availability of various therapeutic modalities aiming to prevent loss of the body protein pool, such as total parenteral nutrition, enteral nutrition designed to provide excessive calories as a form of energy substrate, and protein itself, the loss of body protein cannot be prevented by any of these. Loss of the boyd protein store occurs as a consequence of the alteration of the intermediate metabolism that works for the production of energy substrate. This alteration of substrate metabolism may be linked to the alteration of protein metabolism. However, no specific factors regulating amino acid and protein metabolism have been identified. Thus, further investigations evaluating amino acid and protein metabolism are required to obtain better understanding of metabolic regulation in the body, which may lead to the development of novel and more effective therapeutic modalities for nutrition in the future.
危重病的反应涉及代谢控制的各个方面的改变，有利于身体蛋白质的分解代谢。特别是，由于蛋白质代谢改变而导致的身体蛋白质损失已被报道与危重病患者的存活率呈负相关。尽管有各种旨在预防身体蛋白质池损失的治疗方法，如全胃肠外营养、旨在提供过多卡路里作为能量底物形式的肠内营养和蛋白质本身，但这些方法都不能预防身体蛋白质的损失。身体蛋白质储存的损失是由于中间代谢的改变而发生的，中间代谢是为了生产能量底物而进行的。这种底物代谢的改变可能与蛋白质代谢的改变有关。然而，尚未确定调节氨基酸和蛋白质代谢的特定因素。因此，需要进一步研究氨基酸和蛋白质代谢，以更好地了解身体的代谢调节，这可能导致未来开发出新颖且更有效的营养治疗方法。
