Young L S, Bye R, Scheltinga M, Ziegler T R, Jacobs D O, Wilmore D W
Laboratory of Surgical Metabolism, Brigham and Womens Hospital, Harvard Medical School, Boston, MA 02115.
JPEN J Parenter Enteral Nutr. 1993 Sep-Oct;17(5):422-7. doi: 10.1177/0148607193017005422.
Nutritional effects have traditionally focused on outcomes, such as nitrogen balance, wound healing, or muscle strength. Little emphasis has been placed on how biochemical or physical improvements translate into functional changes as perceived by the patient. Because glutamine (GLN)-supplemented nutrition promotes protein synthesis and improves nitrogen balance, we assessed the mood of individuals participating in a randomized controlled blinded trial receiving GLN solutions. Patients (n = 23) undergoing marrow transplantation were randomized by the research pharmacist to receive either standard total parenteral nutrition (TPN) (control) or GLN-containing TPN (40 g of glutamine total). The solutions were isocaloric and isonitrogenous and were administered until the patient was eating 50% of estimated requirements. Before TPN and on admission to the hospital, the patient completed the Profile of Mood States questionnaire, a standardized test quantifying the degree of tension, depression, anger, vigor, fatigue, and confusion. The patient completed the questionnaire again at the end of TPN near discharge. The tests were scored and the change from baseline for each mood for both groups of patients was calculated at the completion of TPN. The scores for vigor in the control group (delta scores) decreased over the course of hospitalization as would be expected with a serious illness. The group receiving glutamine TPN, however, essentially showed little change in vigor from baseline and the delta score was significantly different from the control group (delta vigor score -0.85 +/- 2.1 in the glutamine group vs. -5.90 +/- 1.7 in the control group; p = .07).(ABSTRACT TRUNCATED AT 250 WORDS)
传统上，营养作用一直侧重于诸如氮平衡、伤口愈合或肌肉力量等结果。很少有人关注生化或身体方面的改善如何转化为患者所感受到的功能变化。由于补充谷氨酰胺（GLN）的营养可促进蛋白质合成并改善氮平衡，我们评估了参与一项接受GLN溶液的随机对照双盲试验的个体的情绪。接受骨髓移植的患者（n = 23）由研究药剂师随机分组，分别接受标准全胃肠外营养（TPN）（对照组）或含GLN的TPN（谷氨酰胺总量为40 g）。这些溶液等热量、等氮量，并持续给予直至患者摄入估计需求量的50%。在开始TPN之前及入院时，患者完成了情绪状态剖面图问卷，这是一项量化紧张、抑郁、愤怒、活力、疲劳和困惑程度的标准化测试。在接近出院时TPN结束时，患者再次完成该问卷。对测试进行评分，并在TPN完成时计算两组患者每种情绪相对于基线的变化。对照组的活力得分（变化得分）在住院期间如预期的那样随着严重疾病而下降。然而，接受谷氨酰胺TPN的组从基线开始活力基本没有变化，且变化得分与对照组有显著差异（谷氨酰胺组的活力变化得分-0.85±2.1，对照组为-5.90±1.7；p = 0.07）。（摘要截短至250字）
