Grünert A, Diesch R, Kilian J, Dölp R
Anaesthesist. 1984 Jan;33(1):11-9.
The study investigates the status of plasma amino acids and their pathological changes under the specific conditions of sepsis in 20 intensive care patients, who were randomized into two groups with and without amino acid support. The study was designed to determine whether the concentration of the free amino acids in plasma or their relative proportions to each other determine the cellular uptake under septic conditions in such a way that would have relevance for the exogenous supply. Sepsis was defined as an increase in body temperature above 38 degrees C, a positive blood culture and changes in the white blood cell picture. Carefully standardized and quality-controlled low-pressure liquid chromatography was used along with a new procedure for data processing, based on personal physiological range with known ranges for individual amino acids. The concentrations of individual amino acids vary widely and did not allow a decision to be made about disturbance of homeostasis. The mean total concentrations varied between 1.27 mmol/l and 4.40 mmol/l. The range was similar whether amino acids were administered or not. This variation was also found in the branched chain amino acids, which were considered to have a specific importance in septic states. Valine varied between 114 mumol/l. The relative proportion of the individual amino acids to the whole amount of amino acids showed less variation and demonstrates that the oxidative action of the liver is able to correct any deviation from the normal and maintains the uptake of amino acids by the cells.(ABSTRACT TRUNCATED AT 250 WORDS)
该研究调查了20名重症监护患者在脓毒症特定条件下血浆氨基酸的状况及其病理变化,这些患者被随机分为接受和未接受氨基酸支持的两组。该研究旨在确定血浆中游离氨基酸的浓度或它们相互之间的相对比例是否以与外源性供应相关的方式决定脓毒症条件下的细胞摄取。脓毒症被定义为体温高于38摄氏度、血培养呈阳性以及白细胞图像变化。使用了经过仔细标准化和质量控制的低压液相色谱法以及一种基于个人生理范围和已知单个氨基酸范围的新数据处理程序。单个氨基酸的浓度差异很大,无法就内环境稳态的紊乱做出决定。平均总浓度在1.27毫摩尔/升和4.40毫摩尔/升之间变化。无论是否给予氨基酸,范围都相似。在支链氨基酸中也发现了这种变化,支链氨基酸在脓毒症状态下被认为具有特殊重要性。缬氨酸在114微摩尔/升之间变化。单个氨基酸相对于氨基酸总量的相对比例变化较小,表明肝脏的氧化作用能够纠正任何偏离正常的情况,并维持细胞对氨基酸的摄取。(摘要截选至250字)