Beylot M, Chassard D, Chambrier C, Guiraud M, Odeon M, Beaufrère B, Bouletreau P
INSERM U 197, Faculté de Médecine Alexis Carrel, Lyon, France.
Crit Care Med. 1994 Jul;22(7):1091-8. doi: 10.1097/00003246-199407000-00007.
To study the effect of a D-beta-hydroxybutyrate infusion on protein metabolism, lipolysis, and endogenous glucose production in septic patients.
Prospective, randomized trial.
Intensive care unit (ICU) and metabolic unit at a university hospital.
Twelve ICU patients with sepsis and six healthy normal subjects.
Septic patients were administered 4-hr infusions of either D-beta-hydroxybutyrate or a control solution, 12 hrs after parenteral nutrition was replaced with an isotonic saline infusion.
The appearance and oxidation rates of leucine (L[1-13C]leucine) and endogenous glucose production (D[6,6-2H2]glucose), plasma fatty acids, and glycerol values were measured before and at the end of infusion of D-beta-hydroxybutyrate or control solution. Unlike the control test, the D-beta-hydroxybutyrate infusion decreased glucose production, fatty acids, and glycerol concentrations, but failed to decrease the leucine oxidation rate.
Exogenous ketone-bodies infusion decreased lipolysis and glucose production in septic patients but had no beneficial effect on protein metabolism, as evaluated with L[1-13C]leucine.
研究D-β-羟基丁酸输注对脓毒症患者蛋白质代谢、脂肪分解及内源性葡萄糖生成的影响。
前瞻性随机试验。
大学医院的重症监护病房（ICU）和代谢病房。
12例脓毒症ICU患者和6名健康正常受试者。
在肠外营养被等渗盐水输注替代12小时后，脓毒症患者接受4小时的D-β-羟基丁酸或对照溶液输注。
在输注D-β-羟基丁酸或对照溶液之前及结束时，测量亮氨酸（L-[1-13C]亮氨酸）的出现率和氧化率、内源性葡萄糖生成（D-[6,6-2H2]葡萄糖）、血浆脂肪酸及甘油值。与对照试验不同，D-β-羟基丁酸输注降低了葡萄糖生成、脂肪酸及甘油浓度，但未能降低亮氨酸氧化率。
以外源性酮体输注降低了脓毒症患者的脂肪分解及葡萄糖生成，但对蛋白质代谢无有益影响，这是通过L-[1-13C]亮氨酸评估得出的。
