Crowe P J, Royle G T, Wagner D, Burke J F
Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, United Kingdom.
J Surg Res. 1989 Oct;47(4):313-8. doi: 10.1016/0022-4804(89)90141-8.
Leucine and glucose turnover were measured using simultaneous infusions of [13C]leucine and [2H]glucose before and during an infusion of Na DL-hydroxybutyrate (Na DL-HB) in overnight-fasted patients the day before and 3 days after total hip replacement. The ketone body infusion before surgery resulted in a significant increase in plasma leucine concentration and leucine turnover, while glucose concentration and turnover decreased. Surgery increased leucine turnover. Ketone body infusion after surgery caused a further increased leucine turnover while turnover fell as before surgery. We suggest that exogenous ketone bodies decrease hepatic glucose production and probably stimulate a rise in protein synthesis above breakdown leading to a decreased nitrogen excretion as observed by other investigators. Despite the metabolic adaptation to trauma, this response was not affected by surgery.
在全髋关节置换术前一天和术后3天，对空腹过夜的患者在输注Na DL-羟基丁酸盐（Na DL-HB）之前和期间，通过同时输注[13C]亮氨酸和[2H]葡萄糖来测量亮氨酸和葡萄糖的周转率。手术前输注酮体导致血浆亮氨酸浓度和亮氨酸周转率显著增加，而葡萄糖浓度和周转率下降。手术增加了亮氨酸周转率。术后输注酮体导致亮氨酸周转率进一步增加，而周转率如术前一样下降。我们认为，外源性酮体可减少肝脏葡萄糖生成，并可能刺激蛋白质合成增加超过分解，导致氮排泄减少，正如其他研究者所观察到的。尽管对创伤有代谢适应，但这种反应不受手术影响。
