Fried R C, Dickerson R N, Guenter P A, Stein T P, Gennarelli T A, Dempsey D T, Buzby G P, Mullen J L
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia.
J Trauma. 1989 Nov;29(11):1558-64. doi: 10.1097/00005373-198911000-00017.
The effect of pentobarbital on nitrogen and energy metabolism was evaluated in seven severely head-injured patients (Glasgow Coma Scale 4.7 +/- 1.7) within the first week postinjury. Measured energy expenditure (% of predicted) was significantly lower in the pentobarbital group (n = 4) versus control (n = 3) (76 +/- 23% versus 132 +/- 28%, respectively, p less than 0.01). Similarly, 24-hour urinary nitrogen excretion was lower for the barbiturate group compared to control (11.2 +/- 4.0 gm versus 19.5 +/- 3.3 gm, respectively, p less than 0.01). No statistical difference was noted for urinary 3-methylhistidine excretion between the barbiturate and control groups (43 +/- 12 mcg/day versus 47 +/- 14 mcg/day, respectively, p = N.S.). Barbiturate therapy decreases measured energy expenditure and reduces nitrogen excretion without significantly altering 3-methylhistidine excretion in head-injured patients. The metabolic effects of pentobarbital may enable the ability to achieve energy and nitrogen equilibrium during metabolic support of acutely head-injured patients.
在受伤后的第一周内，对7名重度颅脑损伤患者（格拉斯哥昏迷量表评分为4.7±1.7）评估了戊巴比妥对氮和能量代谢的影响。戊巴比妥组（n = 4）与对照组（n = 3）相比，测得的能量消耗（预测值的百分比）显著降低（分别为76±23%和132±28%，p<0.01）。同样，巴比妥酸盐组的24小时尿氮排泄量低于对照组（分别为11.2±4.0克和19.5±3.3克，p<0.01）。巴比妥酸盐组和对照组之间的尿3-甲基组氨酸排泄量无统计学差异（分别为43±12微克/天和47±14微克/天，p =无显著性差异）。巴比妥酸盐治疗可降低测得的能量消耗并减少氮排泄，而不会显著改变颅脑损伤患者的3-甲基组氨酸排泄。戊巴比妥的代谢作用可能有助于在急性颅脑损伤患者的代谢支持过程中实现能量和氮平衡。
