Institute of Translational Medicine, University of Liverpool, Department of Women's and Children's Health, Liverpool Women's Hospital, Liverpool, United Kingdom.
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.
Nutr Rev. 2019 Dec 1;77(12):878-889. doi: 10.1093/nutrit/nuz049.
Very preterm neonates (VPNs) are unable to digest breast milk and therefore rely on parenteral nutrition (PN) formulations. This systematic review was prepared following PRISMA-P 2015 guidelines. For the purpose of this review, desirable mean plasma arginine concentration is defined as ≥80 micromoles/L.
The review was performed to answer the following research question: "In VPNs, are high amounts of arginine in PN, compared with low amounts of arginine, associated with appropriate circulating concentrations of arginine?" Therefore, the aims were to 1) quantify the relationship between parenteral arginine intakes and plasma arginine concentrations in PN-dependent VPNs; 2) identify any features of study design that affect this relationship; and 3) estimate the target parenteral arginine dose to achieve desirable preterm plasma arginine concentrations.
The PubMed, Scopus, Web of Science, and Cochrane databases were searched regardless of study design; review articles were not included.
Only articles that discussed amino acid (AA) intake and measured plasma AA profile post PN in VPNs were included. Data were obtained using a data extraction checklist that was devised for the purpose of this review.
Twelve articles met the inclusion criteria. The dose-concentration relationship of arginine content (%) and absolute arginine intake (mg/(kg × d)) with plasma arginine concentrations showed a significant positive correlation (P < 0.001).
Future studies using AA solutions with arginine content of 17%-20% and protein intakes of 3.5-4.0 g/kg per day may be needed to achieve higher plasma arginine concentrations.
极早产儿（VPN）无法消化母乳，因此依赖于肠外营养（PN）配方。本系统评价是按照 PRISMA-P 2015 指南准备的。就本综述而言，理想的平均血浆精氨酸浓度定义为≥80 微摩尔/升。
进行这项综述是为了回答以下研究问题：“在 VPN 中，与低精氨酸 PN 相比，高剂量 PN 中的精氨酸是否与适当的循环精氨酸浓度相关？”因此，目的是 1）量化 PN 依赖的 VPN 中肠外精氨酸摄入量与血浆精氨酸浓度之间的关系；2）确定影响这种关系的研究设计特征；3）估计实现理想早产儿血浆精氨酸浓度的目标肠外精氨酸剂量。
无论研究设计如何，均在 PubMed、Scopus、Web of Science 和 Cochrane 数据库中进行了搜索；未包括综述文章。
仅纳入讨论氨基酸（AA）摄入量并在 VPN 中测量 PN 后血浆 AA 谱的文章。使用专门为此综述设计的数据提取清单获取数据。
符合纳入标准的有 12 篇文章。精氨酸含量（%）和绝对精氨酸摄入量（mg/（kg·d））与血浆精氨酸浓度的剂量-浓度关系呈显著正相关（P<0.001）。
未来可能需要使用精氨酸含量为 17%-20%和蛋白质摄入量为 3.5-4.0 g/kg/d 的 AA 溶液的研究来实现更高的血浆精氨酸浓度。
