Anzai T, Iijima T, Sakata Y, Kanazawa M, Obayashi T
Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan.
Nihon Geka Gakkai Zasshi. 1989 Aug;90(8):1154-60.
The changes of plasma amino acid (AA) pattern on the course of septic multiple organ failure (SMOF), and the effect of branched chain amino acid enriched solution (BCAA-S) on the AA pattern were evaluated in thirteen patients who died of SMOF in ICU. The course of ICU was divided into the following three stages. Stage I was a few days after the admission in ICU. Stage II was severe infected state. Stage III was terminal state. Following results were obtained: 1) Total AA value (TAA) of each stage was 2,693 n.mol/ml, 6,666 n.mol/ml and 19,480 n.mol/ml. 2) BCAA/aromatic AA (B/A) of each stage was 1.4, 1.03 and 1.05. Above values were lower than those of normal one (2.44). 3) Most kinds of AA in stage III were exhibited significantly higher than those of stage I as evaluated in absolute value. 4) In the BCAA-S administered group, B/A exhibited higher values than those of control, but, there was no sign of amelioration for SMOF condition in the former group. In severe infected or septic shock state, AA metabolism is deeply deteriorated. So, we can not decide whether BCAA-S given in this condition plays beneficial effect on the course of SMOF or not.
在13例死于重症监护病房（ICU）的脓毒症多器官功能衰竭（SMOF）患者中，评估了脓毒症多器官功能衰竭病程中血浆氨基酸（AA）模式的变化，以及富含支链氨基酸溶液（BCAA-S）对氨基酸模式的影响。ICU病程分为以下三个阶段。第一阶段是入住ICU几天后。第二阶段是严重感染状态。第三阶段是终末期。得到以下结果：1）各阶段的总氨基酸值（TAA）分别为2693纳摩尔/毫升、6666纳摩尔/毫升和19480纳摩尔/毫升。2）各阶段的支链氨基酸/芳香族氨基酸（B/A）分别为1.4、1.03和1.05。上述值低于正常水平（2.44）。3）以绝对值评估，第三阶段大多数种类的氨基酸显著高于第一阶段。4）在给予BCAA-S的组中，B/A值高于对照组，但前一组中SMOF病情没有改善迹象。在严重感染或脓毒症休克状态下，氨基酸代谢严重恶化。因此，我们无法确定在此种情况下给予BCAA-S对SMOF病程是否起有益作用。
