Georgiannos S N, James A H, Ang B C, Sugden M C, Goode A W
Surgical Unit, Royal London Hospital Medical College, Whitechapel, England.
Int Surg. 1994 Jan-Mar;79(1):84-8.
The work investigated fuel interrelationships in surgical patients infused with saline (Group I) or glucose (Group II) (13 patients in each group) on the day of surgery and subsequently maintained solely on saline until the fifth postoperative day. Blood concentrations of non-esterified fatty acids (NEFA) and ketone bodies were markedly increased in response to surgical stress on the day of surgery only in patients who were not administered carbohydrate. Increased concentrations of lactate and glucose were observed on the day of surgery in patients infused with either saline or glucose. As both fatty acid and ketone body concentrations were decreased by glucose infusion, impaired glucose utilization immediately after surgery is not a simple consequence of increased oxidation of lipid fuels. Glucose and lactate concentrations declined after the day of surgery. Despite a progressive fall in plasma non-esterified fatty acid concentrations from the first to fifth post-operative days, blood ketone body concentrations were strikingly elevated in both groups of patients. The findings emphasize the role of the liver in post-operative fatty acid turnover.
该研究调查了手术当天输注生理盐水（第一组）或葡萄糖（第二组）（每组13例患者）的手术患者的燃料相互关系，随后仅维持生理盐水输注直至术后第五天。仅在未给予碳水化合物的患者中，手术当天非酯化脂肪酸（NEFA）和酮体的血浓度因手术应激而显著增加。在输注生理盐水或葡萄糖的患者中，手术当天观察到乳酸和葡萄糖浓度升高。由于输注葡萄糖会降低脂肪酸和酮体浓度，术后立即出现的葡萄糖利用受损并非脂质燃料氧化增加的简单结果。术后第一天后葡萄糖和乳酸浓度下降。尽管从术后第一天到第五天血浆非酯化脂肪酸浓度逐渐下降，但两组患者的血酮体浓度均显著升高。这些发现强调了肝脏在术后脂肪酸周转中的作用。
