重症监护中长时间全胃肠外营养期间的代谢变化
Metabolic changes during prolonged total parenteral nutrition in intensive care.
作者信息
Castelli E, Cetrullo C, Zanello M
出版信息
Resuscitation. 1978;6(4):235-42. doi: 10.1016/0300-9572(78)90003-5.
Intensive care patients receiving prolonged total parenteral nutrition (TPN) developed alterations of liver function tests, seen in the activity of certain serum enzymes. Hepatomegaly and jaundice sometimes appeared. The changes in chemical pathology were in serum transaminases activity (GOT, GPT, GDH); alkaline phosphatase and gamma-glutamyltranspeptidase as indices of cholestasis; lactate dehydrogenase, hydroxybutyrate dehydrogenase and creatine phosphokinase, as enzymes related to energy metabolism; pseudocholinesterase, as a protein metabolism-related enzyme. The possible causes of these alterations in critically ill patients undergoing TPN are considered and a functional final metabolic interpretation is proposed.
接受长期全胃肠外营养（TPN）的重症监护患者出现肝功能检查异常，表现为某些血清酶活性的变化。有时会出现肝肿大和黄疸。化学病理学变化包括血清转氨酶活性（谷草转氨酶、谷丙转氨酶、谷氨酸脱氢酶）；碱性磷酸酶和γ-谷氨酰转肽酶作为胆汁淤积的指标；乳酸脱氢酶、羟丁酸脱氢酶和肌酸磷酸激酶作为与能量代谢相关的酶；假性胆碱酯酶作为与蛋白质代谢相关的酶。本文考虑了接受TPN的重症患者出现这些异常的可能原因，并提出了功能性最终代谢解释。
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