Mattox T W, Brown R O, Boucher B A, Buonpane E A, Fabian T C, Luther R W
Departments of Clinical Pharmacy/Surgery, University of Tennessee, Memphis.
JPEN J Parenter Enteral Nutr. 1988 Nov-Dec;12(6):592-6. doi: 10.1177/0148607188012006592.
The purpose of this study was to evaluate the use of serum fibronectin and serum somatomedin-C as nutritional markers during enteral nutrition support (ENS) of critically ill, traumatized patients using an enteral product containing high concentrations of branched-chain amino acids. Twelve critically injured patients received a standard enteral formula with 30 g of a 44% branched-chain amino acid supplement added to each liter of formula. Fibronectin concentration, somatomedin-C concentration, and nitrogen balance were measured on study days 1, 4, 7, 14, 21, 28 or until adequate oral intake began. Both fibronectin and somatomedin-C concentrations increased significantly from baseline by day 7 of ENS. Nitrogen balance increased significantly from baseline by day 4. On days 14 and 21, only somatomedin-C and nitrogen balance increased significantly from baseline. Nitrogen balance was significantly correlated with somatomedin-C concentration (r = 0.53, p less than 0.01), cumulative caloric intake (r = 0.68, p less than 0.01), and cumulative nitrogen intake (r = 0.72, p less than 0.01). The results of this study suggest that serum somatomedin-C is useful and serum fibronectin has potential in monitoring nutrition support response in critically ill, traumatized patients.
本研究的目的是评估在使用含高浓度支链氨基酸的肠内产品对重症创伤患者进行肠内营养支持（ENS）期间，血清纤维连接蛋白和血清生长调节素C作为营养指标的作用。12例重症受伤患者接受了标准肠内配方，每升配方中添加了30克44%的支链氨基酸补充剂。在研究第1、4、7、14、21、28天或直至开始有足够的口服摄入量时，测量纤维连接蛋白浓度、生长调节素C浓度和氮平衡。在肠内营养支持第7天时，纤维连接蛋白和生长调节素C浓度均较基线水平显著升高。氮平衡在第4天时较基线水平显著升高。在第14天和21天时，只有生长调节素C和氮平衡较基线水平显著升高。氮平衡与生长调节素C浓度（r = 0.53，p<0.01）、累积热量摄入（r = 0.68，p<0.01）和累积氮摄入（r = 0.72，p<0.01）显著相关。本研究结果表明，血清生长调节素C在监测重症创伤患者的营养支持反应方面是有用的，血清纤维连接蛋白也有此潜力。
