重大外科疾病中的大量氮流失：对心脏质量和功能的影响。
Massive nitrogen loss in critical surgical illness: effect on cardiac mass and function.
作者信息
Hill A A, Plank L D, Finn P J, Whalley G A, Sharpe N, Clark M A, Hill G L
机构信息
University Department of Surgery, Auckland Hospital, New Zealand.
出版信息
Ann Surg. 1997 Aug;226(2):191-7. doi: 10.1097/00000658-199708000-00011.
OBJECTIVE
The authors measured cardiac mass and function to determine whether these changed in patients who were critically ill who were losing large amounts of nitrogen from the body.
SUMMARY BACKGROUND DATA
The large losses of body nitrogen that occur in patients with protein-energy malnutrition are associated with a loss of cardiac mass and function. It is not known if this also occurs in patients who were critically ill who are losing massive amounts of nitrogen.
METHODS
Once hemodynamically stable, 13 patients who were critically ill underwent sequential measurements of left ventricular mass (LVM) and function, total body nitrogen (TBN), total body potassium, body weight, fat-free mass, and limb muscle mass.
RESULTS
Over a 21-day study period, there was no change in LVM or function despite falls of 14% and 21% in TBN and total body potassium, respectively, a 21% fall in limb muscle mass, and a deterioration in skeletal muscle function by approximately 40%.
CONCLUSIONS
In patients who were critically ill, cardiac mass does not decrease and function does not deteriorate after hemodynamic stability has been achieved despite massive losses of protein from the body.
目的
作者测量了心脏质量和功能，以确定在大量氮从体内流失的重症患者中这些指标是否发生变化。
总结背景数据
蛋白质 - 能量营养不良患者体内大量氮流失与心脏质量和功能丧失有关。目前尚不清楚在大量氮流失的重症患者中是否也会出现这种情况。
方法
13名重症患者血流动力学稳定后，对其左心室质量（LVM）和功能、全身氮（TBN）、全身钾、体重、去脂体重和肢体肌肉质量进行了连续测量。
结果
在为期21天的研究期间，尽管TBN和全身钾分别下降了14%和21%，肢体肌肉质量下降了21%，骨骼肌功能恶化了约40%，但LVM或功能没有变化。
结论
在重症患者中，尽管身体蛋白质大量流失，但在血流动力学稳定后，心脏质量不会下降，功能也不会恶化。
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