Iapichino G, Ronzoni G, Beck E, Di Mauro P, Caccamo L, Fara C, Ferraris S, Gislon M, Paone G, Prato P
Minerva Chir. 1989 Sep 30;44(18):1965-9.
Plasma amino acids profile is assumed to be a good index of whole body amino acids balance and in particular to give information on the actual control of the transplanted liver on protein metabolism. Variations in plasma amino acids profile were studied in 12 patients undergoing orthotopic liver transplantation. Total parenteral nutrition (TPN) was maintained at 26.05 +/- 1.53 kcal/kg and 0.117 +/- 0.01 gN/kg until the 7th postoperative day. Following this, an enteral nutrition (EN) was added as to maintain a mixed metabolic therapy at 30.28 +/- 2.76 kcal/kg and 0.198 +/- 0.01 gN/kg. Such a treatment completely satisfied the caloric needs, while nitrogen input was prudently kept low in accordance to the lack of data on the metabolic effectiveness of the transplanted liver. Amino acids profiles showed an early metabolic recovery of the new liver. Therefore nitrogen input could be higher and more adequate to nitrogen needs.
血浆氨基酸谱被认为是全身氨基酸平衡的良好指标,尤其能提供关于移植肝脏对蛋白质代谢实际控制情况的信息。对12例接受原位肝移植的患者的血浆氨基酸谱变化进行了研究。术后第7天前,全胃肠外营养(TPN)维持在26.05±1.53千卡/千克和0.117±0.01克氮/千克。此后,添加肠内营养(EN),以维持30.28±2.76千卡/千克和0.198±0.01克氮/千克的混合代谢疗法。这种治疗完全满足了热量需求,同时根据移植肝脏代谢有效性数据的缺乏,谨慎地将氮输入量保持在较低水平。氨基酸谱显示新肝脏早期代谢恢复。因此,氮输入可以更高且更符合氮需求。