Raurich J M, Llompart-Pou J A, García-de-Lorenzo A, Buño Soto A, Marsé P, Frontera G, Pérez-Bárcena J
Servei de Medicina Intensiva, Hospital Universitari Son Espases, Carretera Valldemossa, 79, 07010, Palma de Mallorca, Illes Balears, Spain.
Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.
Eur J Trauma Emerg Surg. 2018 Dec;44(6):869-876. doi: 10.1007/s00068-017-0851-1. Epub 2017 Oct 4.
Our purpose was to assess the amino acids' (AAs) profile in trauma patients and to assess the effect of the route of nutrition and the exogenous ALA-GLN dipeptide supplementation on plasma AAs' concentration.
This is a secondary analysis of a previous randomized controlled trial. On day 1 and day 6 after trauma, plasma concentration of 25 AAs was measured using reverse phase high-performance liquid chromatography. Results were analyzed in relation to the route of nutrition and supplementation of ALA-GLN dipeptide. Differences between plasma AAs' concentrations at day 1 and day 6 were evaluated using the Student's t test or Mann-Whitney-Wilcoxon test. One-way ANOVA and the Kruskal-Wallis test were used to compare groups. A two-sided p value less than 0.05 was considered statistically significant.
Ninety-eight patients were analyzed. Mean plasma concentrations at day 1 were close to the lower normal level for most AAs. At day 6 we found an increase in the eight essential AAs' concentrations and in 9 out of 17 measured non-essential AAs. At day 6 we found no differences in plasma concentrations for the sum of all AAs (p = .72), glutamine (p = .31) and arginine (p = .23) distributed by the route of nutrition. Administration of ALA-GLN dipeptide increased the plasma concentration of alanine (p = .004), glutamine (p < .001) and citrulline (p = .006).
We found an early depletion of plasma AAs' concentration which partially recovered at day 6, which was unaffected by the route of nutrition. ALA-GLN dipeptide supplementation produced a small increase in plasma levels of glutamine and citrulline.
我们的目的是评估创伤患者的氨基酸（AA）谱，并评估营养途径和外源性丙氨酰 - 谷氨酰胺二肽补充对血浆氨基酸浓度的影响。
这是一项对先前随机对照试验的二次分析。在创伤后第1天和第6天，使用反相高效液相色谱法测量25种氨基酸的血浆浓度。根据营养途径和丙氨酰 - 谷氨酰胺二肽补充情况分析结果。使用学生t检验或曼 - 惠特尼 - 威尔科克森检验评估第1天和第6天血浆氨基酸浓度之间的差异。使用单向方差分析和克鲁斯卡尔 - 沃利斯检验比较各组。双侧p值小于0.05被认为具有统计学意义。
对98名患者进行了分析。第1天大多数氨基酸的平均血浆浓度接近正常下限水平。在第6天，我们发现8种必需氨基酸的浓度以及17种测得的非必需氨基酸中的9种有所增加。在第6天，我们发现按营养途径分布的所有氨基酸总和（p = 0.72）、谷氨酰胺（p = 0.31）和精氨酸（p = 0.23）的血浆浓度没有差异。丙氨酰 - 谷氨酰胺二肽的给药增加了丙氨酸（p = 0.004）、谷氨酰胺（p < 0.001）和瓜氨酸（p = 0.006）的血浆浓度。
我们发现血浆氨基酸浓度早期降低，在第6天部分恢复，这不受营养途径的影响。补充丙氨酰 - 谷氨酰胺二肽使血浆谷氨酰胺和瓜氨酸水平略有升高。
