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静脉输注氨基酸对人体内脏及全身氧耗、血流和体温的影响。

Effects of i.v. amino acids on human splanchnic and whole body oxygen consumption, blood flow, and blood temperatures.

作者信息

Brundin T, Wahren J

机构信息

Department of Clinical Physiology, Karolinska Hospital, Stockholm, Sweden.

出版信息

Am J Physiol. 1994 Mar;266(3 Pt 1):E396-402. doi: 10.1152/ajpendo.1994.266.3.E396.

DOI:10.1152/ajpendo.1994.266.3.E396
PMID:8166259
Abstract

The thermic effect of amino acid administration was examined in healthy subjects. Pulmonary and splanchnic oxygen uptake, cardiac output, splanchnic blood flow, and blood temperatures were measured in eight healthy men before and during 2.5 h of intravenous infusion of 600 kJ of a mixture of 19 amino acids. Indirect calorimetry and catheter techniques were used, including thermometry in arterial and a hepatic venous blood. During the infusion, pulmonary oxygen uptake rose progressively from a basal value of 269 +/- 6 to 321 +/- 8 ml/min after 2.5 h. The splanchnic oxygen consumption increased from a basal level of 64 +/- 4 to a peak value of 91 +/- 7 ml/min after 2 h of infusion. The 2.5 h average splanchnic proportion of the amino acid-induced whole body thermogenesis was 51 +/- 11%. Cardiac output increased from 6.2 +/- 0.3 in the basal state to 7.3 +/- 0.4 l/min, whereas the splanchnic blood flow remained unchanged during the infusion period. The arteriohepatic venous oxygen difference increased from 51 +/- 4 in the basal state to 65 +/- 5 ml/l after 2 h of amino acid infusion. The blood temperature rose by approximately 0.25 degrees C during the amino acid infusion, reflecting an increased heat accumulation in the body. It is concluded that the splanchnic tissues account for approximately one-half of the amino acid-induced whole body thermogenesis, that amino acid infusion augments blood flow in the extrasplanchnic but not in the splanchnic tissues, and stimulates the accumulation of heat in the body most likely via a resetting of the central thermosensors.

摘要

在健康受试者中研究了氨基酸输注的热效应。在8名健康男性静脉输注600 kJ的19种氨基酸混合物2.5小时之前和期间,测量了肺和内脏的氧摄取、心输出量、内脏血流量和体温。采用间接测热法和导管技术,包括测量动脉血和肝静脉血的温度。在输注过程中,肺氧摄取量从基础值269±6 ml/min逐渐上升,2.5小时后达到321±8 ml/min。内脏氧消耗量从基础水平64±4 ml/min增加,输注2小时后达到峰值91±7 ml/min。在2.5小时内,氨基酸诱导的全身产热中内脏所占比例平均为51±11%。心输出量从基础状态的6.2±0.3 l/min增加到7.3±0.4 l/min,而在内脏血流量在输注期间保持不变。氨基酸输注2小时后,动脉-肝静脉氧差从基础状态的51±4 ml/l增加到65±5 ml/l。在氨基酸输注期间,体温上升约0.25℃,这反映了体内热量积累增加。得出的结论是,内脏组织约占氨基酸诱导的全身产热的一半,氨基酸输注增加了内脏外组织的血流量,但没有增加内脏组织的血流量,并且很可能通过重置中枢温度传感器来刺激体内热量的积累。

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