中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
7期
496-499
,共4页
周波%任建安%陈钰%顾国胜%陈军%黎介寿
週波%任建安%陳鈺%顧國勝%陳軍%黎介壽
주파%임건안%진옥%고국성%진군%려개수
腹腔感染%肠瘘%白蛋白合成速率%气相色谱质谱
腹腔感染%腸瘺%白蛋白閤成速率%氣相色譜質譜
복강감염%장루%백단백합성속솔%기상색보질보
Intra-abdominal infection%Intestinal fistula%Albumin fractional synthesis rate%Gas chromatography/mass spectrometry
目的 探讨复杂腹腔感染对白蛋白合成速率的影响.方法 前瞻性收集2009年12月至2010年10月间南京军区南京总医院普通外科研究所收治的肠瘘合并复杂腹腔感染病例(感染组,8例);另选取同期8名年龄、性别、BMI相匹配的健康志愿者作为对照组.受试者在空腹状态下经外周静脉给予首剂量无菌L-[ring-2H5]-苯丙氨酸溶液(4 μmol/kg),继之以6 μmol·kg-1·h-1的速度持续输注6 h.输注前和输注后的每小时取3 ml动脉血;通过GC-MS测定血浆游离氨基酸和掺入到白蛋白中L-[ring-2H5]-苯丙氨酸的同位素丰度.结果 感染组患者血清总蛋白和白蛋白浓度分别为(62.2±1.0)g/L和(32.5±4.0)g/L,显著低于对照组[(74.2±1.7)g/L和(46.1±2.6)g/L;均P<0.05].感染组患者C反应蛋白、白细胞计数和体温3项全身炎性反应指标均高于对照组(均P<0.05).感染组患者白蛋白合成速率为(5.3±1.6)%/d,显著低于正常对照组的(7.8±1.2)%/d,差异有统计学意义(P<0.05).血浆游离氨基酸谱显示,感染组患者血浆谷氨酸高于对照组,苯丙氨酸和脯氨酸低于对照组(均P<0.05).结论 复杂腹腔感染可明显抑制白蛋白合成,是腹腔感染患者低白蛋白血症的原因之一.
目的 探討複雜腹腔感染對白蛋白閤成速率的影響.方法 前瞻性收集2009年12月至2010年10月間南京軍區南京總醫院普通外科研究所收治的腸瘺閤併複雜腹腔感染病例(感染組,8例);另選取同期8名年齡、性彆、BMI相匹配的健康誌願者作為對照組.受試者在空腹狀態下經外週靜脈給予首劑量無菌L-[ring-2H5]-苯丙氨痠溶液(4 μmol/kg),繼之以6 μmol·kg-1·h-1的速度持續輸註6 h.輸註前和輸註後的每小時取3 ml動脈血;通過GC-MS測定血漿遊離氨基痠和摻入到白蛋白中L-[ring-2H5]-苯丙氨痠的同位素豐度.結果 感染組患者血清總蛋白和白蛋白濃度分彆為(62.2±1.0)g/L和(32.5±4.0)g/L,顯著低于對照組[(74.2±1.7)g/L和(46.1±2.6)g/L;均P<0.05].感染組患者C反應蛋白、白細胞計數和體溫3項全身炎性反應指標均高于對照組(均P<0.05).感染組患者白蛋白閤成速率為(5.3±1.6)%/d,顯著低于正常對照組的(7.8±1.2)%/d,差異有統計學意義(P<0.05).血漿遊離氨基痠譜顯示,感染組患者血漿穀氨痠高于對照組,苯丙氨痠和脯氨痠低于對照組(均P<0.05).結論 複雜腹腔感染可明顯抑製白蛋白閤成,是腹腔感染患者低白蛋白血癥的原因之一.
목적 탐토복잡복강감염대백단백합성속솔적영향.방법 전첨성수집2009년12월지2010년10월간남경군구남경총의원보통외과연구소수치적장루합병복잡복강감염병례(감염조,8례);령선취동기8명년령、성별、BMI상필배적건강지원자작위대조조.수시자재공복상태하경외주정맥급여수제량무균L-[ring-2H5]-분병안산용액(4 μmol/kg),계지이6 μmol·kg-1·h-1적속도지속수주6 h.수주전화수주후적매소시취3 ml동맥혈;통과GC-MS측정혈장유리안기산화참입도백단백중L-[ring-2H5]-분병안산적동위소봉도.결과 감염조환자혈청총단백화백단백농도분별위(62.2±1.0)g/L화(32.5±4.0)g/L,현저저우대조조[(74.2±1.7)g/L화(46.1±2.6)g/L;균P<0.05].감염조환자C반응단백、백세포계수화체온3항전신염성반응지표균고우대조조(균P<0.05).감염조환자백단백합성속솔위(5.3±1.6)%/d,현저저우정상대조조적(7.8±1.2)%/d,차이유통계학의의(P<0.05).혈장유리안기산보현시,감염조환자혈장곡안산고우대조조,분병안산화포안산저우대조조(균P<0.05).결론 복잡복강감염가명현억제백단백합성,시복강감염환자저백단백혈증적원인지일.
Objective To study the impact of complicated intra-abdominal infections on albumin synthesis rate. Methods Eight patients with complicated intra-abdominal infections associated with intestinal fistula were admitted to the Research Institute of General Surgery at the Jinling Hospital between December 2009 and October 2010. Eight healthy volunteers matched for age, sex, and amino acid pool and from albumin were determined by gas chromatography/mass spectrometry analysis. Results Both plasma total protein concentration (62.2 ±1.0) g/L and plasma albumin concentration (32.5 ±4.0) g/L in patients with complicated intra-abdominal infection were lower compared with controls[(74.2±1.7) g/L and (46.1±2.6) g/L, both P<0.05]. Body temperature, neutrophil count and plasma C-reactive protein concentration in patients with infection were significantly greater than the levels in control subjects(P<0.05). Albumin synthesis rate in patients with intra-abdominal infection was significantly lower than that in the control group[(5.3±1.6)%/d and(7.8±1.2)%/d respectively, P<0.05]. The measurement of plasma free amino acid concentration showed that plasma glutamic acid level was greater than that in control subjects, and that plasma phenylalanine and proline levels were lower than those in controls. Conclusion Complicated intra-abdominal infection inhibits albumin synthesis rate in patients with intestinal fistula, which may partially contribute to the decrease of plasma albumin concentration.
