Clague M B, Carmichael M J, Keir M J, Rogaly E, Wright P D, Johnston I D
Ann Surg. 1982 Jul;196(1):53-8. doi: 10.1097/00000658-198207000-00012.
Following injury there is increased synthesis of several plasma proteins. During a constant rate infusion of 1-(1-14C) leucine some of the labeled amino acid became incorporated into plasma proteins, the amount being readily determined after precipitation with perchloric acid. This value was correlated with the clinical state of the patient to see if an index of severity of injury could be derived. Before operation 6.7 +/- 0.5% (mean +/- SD, n = 16) of the infused labeled amino acid was incorporated in asymptomatic patients, irrespective of their dietary intakes, while in the presence of symptomatology this value rose, correlating with tumor staging in patients with colorectal neoplasia (r = 0.988, p = 0.001). It returned to normal following tumor resection, but was elevated in the presence of recurrence or residual disease. After operation it also rose, being maximal in the early postoperative period and following the more major surgical procedures, the increase correlating with the change in cortisol level in patients following cholecystectomy (r = 0.84, p less than 0.01; n = 8). The pattern of distribution of the label among the plasma proteins did not change with increased incorporation. The increase in incorporation of 1-(1-14C) leucine into plasma proteins would appear to offer a good index for severity of injury of activity of a disease state.
受伤后几种血浆蛋白的合成会增加。在以恒定速率输注1-(1-¹⁴C)亮氨酸期间，一些标记的氨基酸会掺入血浆蛋白中，用高氯酸沉淀后即可轻松测定其含量。该值与患者的临床状态相关，以查看是否可以得出损伤严重程度的指标。手术前，无论饮食摄入量如何，无症状患者中6.7±0.5%（平均值±标准差，n = 16）的输注标记氨基酸会被掺入，而在有症状的情况下，该值会升高，与结直肠肿瘤患者的肿瘤分期相关（r = 0.988，p = 0.001）。肿瘤切除后该值恢复正常，但在复发或残留疾病存在时会升高。手术后该值也会升高，在术后早期和进行更大型的外科手术后达到最大值，这种升高与胆囊切除术后患者皮质醇水平的变化相关（r = 0.84，p < 0.01；n = 8）。随着掺入量增加，标记物在血浆蛋白中的分布模式没有改变。1-(1-¹⁴C)亮氨酸掺入血浆蛋白的增加似乎为疾病状态的损伤严重程度或活性提供了一个良好的指标。
