摘要
目的：观察山羊缺血再灌注复合内毒素攻击诱发多器官功能障碍综合征（ＭＯＤＳ）时血浆游离氨基酸的代谢变化及其与肿瘤坏死因子（ＴＮＦ）变化的关系。方法：以北京地区雄性成年山羊为模型，经动脉导管快速放血，造成低血容量性休克后再复苏，复苏后２４小时经门静脉持续输入内毒素诱发ＭＯＤＳ。结果：致伤后第５日支链氨基酸与芳香氨基酸比值（ＢＣＡＡ／ＡＡＡ）显著降低，伤后第３日起尿氮排出增加，第５日增加更加显著（Ｐ＜０．０５）；尿三甲基组氨酸（３Ｍｅｈｉｓ）在伤后３日和５日排出显著升高；血ＢＣＡＡ／ＡＡＡ、苯丙氨酸／酪氨酸（Ｐｈｅ／Ｔｙｒ）和尿３Ｍｅｈｉｓ的变化与ＴＮＦ变化高度相关；Ｐｈｅ／Ｔｙｒ与丙氨酸转氨酶（ＡＬＴ）变化呈正相关。结论：山羊在失血后再灌注及内毒素的双重作用下，ＴＮＦ可能介导了骨骼肌蛋白质分解代谢增强。
Objective:To investigate changes in plasma free amino acids concentrations and their relationship to release of tumor necrosis factor (TNF) in multiple organ dysfunction syndrome (MODS).Methods:A goat model of MODS was reproduced by hemorrhagic shock combined with endotoxin infusion.Results:It showed that ratios of branched amino acid to aromatic amino acids (BCAA/AAA) were significantly decreased while ratio of Phe/Tyr was increased after injury together with marked elevation of nitrogen as well as 3methyhistidine in urine.Similarly,Plasma TNF levels were also elevated after injury.In addition,positive correlations were found between TNF and BCAA/AAA or Phe/Tyr or 3methyhistidine,and between Phe/Tyr and alanine aminotransferase(ALT) respectively( r =-0 914 9,0 815 1,0 950 3 and 0 625 0, P <0 05 or P <0 01).Conclusions:These data suggest that disturbance in metabolism of plasma free amino acids may result in body catabolism and liver amino acids transport dysfunction,which appears to be associated with release of plasma TNF.
出处
《中国危重病急救医学》
CSCD
1999年第8期481-484,共4页
Chinese Critical Care Medicine
基金
全军"九五"医学科研规划指令性课题
关键词
缺血
再灌注损伤
内毒素
氨基酸
TNF
MODS
goat
ischemiareperfusion injury
endotoxin
amino acid
tumor necrosis factor
