感染性休克患者血氨基酸浓度变化的研究

Changes of Blood Amino Acid during Septic Shock

本研究观察感染性休克患者血氨基酸浓度的变化及与急性生理学和慢性健康状况评估Ⅱ(APACHEⅡ)评分、多器官功能障碍(MODS)评分、血乳酸(Lac)浓度的相关性。纳入38例感染性休克患者,测定入重症加强护理病房(ICU)后氨基酸浓度并记录APACHEⅡ评分、MODS评分、血Lac及预后,比较死亡组和存活组的氨基酸浓度。入住ICU后部分氨基酸浓度出现下降或升高,但均在正常范围内。死亡组的亮氨酸、缬氨酸、色氨酸(Trp)、甲硫氨酸(Met)、半胱氨酸、谷氨酸、脯氨酸(Pro)浓度低于存活组;死亡组的苯丙氨酸(Phe)、同型半胱氨酸浓度高于存活组。Met浓度变化与APACHEⅡ、MODS评分呈正相关;Trp浓度变化与MODS评分呈正相关;Phe浓度变化与血Lac呈正相关,Pro浓度变化与血Lac浓度呈负相关。入ICU后,感染性休克患者的血氨基酸浓度出现了不同程度的波动。Met、Trp、Phe、Pro浓度与APACHEⅡ评分、MODS评分、血Lac具有相关性。

The aim of this study is to observe blood amino acid levels of septic shock patients. Changes in amino acid concentrations, correlations with APACHEⅡ score, MODS score, blood Lac were studied. 38 septic shock patients who were admitted to the ICU were collected. On ICU, the levels of 22 kinds of blood amino acids were measured. APACHE Ⅱ scores, SOFA scores, Lac levels were recorded. Patients were divided into survival group and death group to compare the concentrations of amino acids. The levels of the different amino acids gradually increased, decreased following ICU admission. The concentrations of Leu, Val, Trp, Met, Cys, Glu, Pro in non-survivors were lower and statistically significant. Compared with survivors, concentrations of Phe, Hcy in non-survivors were significantly higher. Changes in Met concentration had positive relation to the scores. Changes in Trp concentrations and MODS scores were positive correlated. Changes in Phe concentrations had positive relation to the blood Lac. Changes in Pro concentrations correlated negatively to the blood Lac. Septic shock patients had disorders of amino acid metabolism. The levels of the different amino acids gradually increased or decreased over time. There was a correlation among the changes in Met, Trp, Phe, Pro concentrations with the scores, Lac concentration.