Pearl R H, Clowes G H, Hirsch E F, Loda M, Grindlinger G A, Wolfort S
J Trauma. 1985 Aug;25(8):777-83. doi: 10.1097/00005373-198508000-00008.
Sepsis, the commonest cause of late death following severe trauma, is related in part to inadequate uptake of amino acids (AA) and synthesis by the liver and other central tissues of proteins essential to immunological defense. Since 'central plasma clearance rate' of amino acids (CPCR-AA) has been found to reflect these functions, serial measurements of CPCR-AA were made in 32 seriously injured patients of whom ten died (31%), nine of sepsis. The mean Index Severity Score on admission for survivors was 31 +/- 1.8 and in deaths 34 +/- 3.9 (N.S.). The blood plasma AA concentrations were not significantly different. However, early in the course before the onset of infection, CPCR-AA in surviving patients was 227 +/- 30 and in those who ultimately died 83 +/- 24 ml/M2/min (p less than 0.001). Later during sepsis the values of CPCR-AA were 176 +/- 28 and 85 +/- 14 ml/M2/min, respectively (p less than 0.01). Thus CPCR-AA appears to be of value as an indicator of amino acid utilization by central tissues and as a predictor of survival or death following severe trauma.
脓毒症是严重创伤后晚期死亡的最常见原因，部分与肝脏和其他对免疫防御至关重要的中心组织对氨基酸（AA）摄取不足及蛋白质合成不足有关。由于已发现氨基酸的“中心血浆清除率”（CPCR-AA）可反映这些功能，因此对32例重伤患者进行了CPCR-AA的系列测量，其中10例死亡（31%），9例死于脓毒症。幸存者入院时的平均严重程度指数评分为31±1.8，死亡者为34±3.9（无显著性差异）。血浆氨基酸浓度无显著差异。然而，在感染发生前的病程早期，存活患者的CPCR-AA为227±30，最终死亡患者的CPCR-AA为83±24 ml/M2/min（p<0.001）。在脓毒症后期，CPCR-AA值分别为176±28和85±1十四ml/M2/min（p<0.01）。因此，CPCR-AA似乎可作为中心组织氨基酸利用的指标以及严重创伤后生存或死亡的预测指标。
