Roth E
Z Exp Chir Transplant Kunstliche Organe. 1985;18(3):150-6.
Cachexia as a consequence of a catabolic state (stress metabolism) and cachexia as a consequence of too small food intake (inanition metabolism) have to be distinguished from each other fundamentally. A typical amino acid distribution in plasma, muscle, and liver can be observed in the protein catabolic patient. The glutamine metabolism seemed to be of special interest in the severe catabolic patient (e. g. sepsis). Glutamine is the amino acid with the biggest part of the free amino acid pool. This glutamine pool is reduced in the protein catabolic patient. A connexion seems to exist between the lower muscle glutamine concentration and the prognosis of the patient. The parenteral nutrition can stimulate the protein synthesis, but not suppress the protein hydrolysis. Perhaps catabolic factors as, for instance, interleucine I take part in that. These stimulate the protein hydrolysis over the prostaglandin metabolism.
必须从根本上区分作为分解代谢状态（应激代谢）结果的恶病质和食物摄入量过少（饥饿代谢）导致的恶病质。在蛋白质分解代谢的患者中，可以观察到血浆、肌肉和肝脏中典型的氨基酸分布。谷氨酰胺代谢在严重分解代谢的患者（如脓毒症患者）中似乎特别值得关注。谷氨酰胺是游离氨基酸池中占比最大的氨基酸。在蛋白质分解代谢的患者中，这个谷氨酰胺池会减少。较低的肌肉谷氨酰胺浓度与患者的预后之间似乎存在联系。肠外营养可以刺激蛋白质合成，但不能抑制蛋白质水解。也许诸如白细胞介素I等分解代谢因子参与其中。这些因子通过前列腺素代谢刺激蛋白质水解。
