Mårtensson J, Larsson J, Schildt B
J Trauma. 1985 May;25(5):427-32. doi: 10.1097/00005373-198505000-00010.
The metabolic effects of TPN containing high amounts of amino acids (18 gm N) was evaluated with respect to sulfur amino acid metabolism and protein breakdown in nine severely burned patients. The results were compared to corresponding data from burned patients receiving more moderate amounts of amino acids (9.2 gm N) or isocaloric amounts of carbohydrate and fat. Significantly increased urinary excretion and intracellular muscle tissue concentrations of methionine were found in patients receiving the concentrated amino acid solution, probably reflecting a combined effect of the injury and an increased load of the compound. These patients also showed a reduced oxidation of sulfur amino acids to inorganic sulfate, which may reflect an increased protein synthesis during treatment. A significantly decreased urinary excretion of 3-methyl-histidine and mercaptolactate was found in patients receiving the concentrated amino acid solution, probably reflecting a decreased breakdown of body protein. The findings favor the hypothesis of an anabolic effect of the new amino acid solution in burned patients during the early catabolic phase, but also emphasize the importance of monitoring the amounts of amino acids, e.g., methionine, given.
对9例严重烧伤患者，就含大量氨基酸（18克氮）的全胃肠外营养（TPN）在含硫氨基酸代谢及蛋白质分解方面的代谢效应进行了评估。将结果与接受中等量氨基酸（9.2克氮）或等热量碳水化合物和脂肪的烧伤患者的相应数据进行了比较。接受浓缩氨基酸溶液的患者尿中蛋氨酸排泄及细胞内肌肉组织浓度显著增加，这可能反映了损伤及该化合物负荷增加的综合作用。这些患者还表现出含硫氨基酸向无机硫酸盐的氧化减少，这可能反映了治疗期间蛋白质合成增加。接受浓缩氨基酸溶液的患者尿中3-甲基组氨酸和巯基乳酸排泄显著减少，这可能反映了机体蛋白质分解减少。这些发现支持新氨基酸溶液在烧伤患者早期分解代谢阶段具有合成代谢作用这一假说，但也强调了监测所给予氨基酸量（如蛋氨酸）的重要性。
