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| 篇名 |
Werum Amino Acid Pattern in Total Parenteral Nutrition with Essential Amino Acids as the Sole Nitrogen Source |
| 作者 |
Jenq-Chang Lee, Hong-Shiee Lai, Wei-Jao Chen, Shan-Tair Wang, Chih-Jen Chang |
| 卷期/出版年月 |
28卷5期 (1995/10) |
| 頁次 |
341-348 |
| 摘要 |
Hyperammonemic encephalopathy was found in every rat given total parenteral nutrition (TPN) with essential amino acids (EAA) as the only source of nitrogen in a previous experiment here. The amino acid pattern in the serum was checked to determine its mechanism. Forty male Long-Evan rats were divided into five equal groups receiving feed αd libitum or with different formulae of TPN. The serum ammonia levels of the rats given TPN with EAA as the only source of nitrogen were significantly higher than that of the control group given food αd libitum and groups given TPN for the same number of days but with mixed amino acids (MAA）as the source of nitrogen. The mean concentration of essential and nonessential amino acids of the groups given TPN with EAA was not distinct from that of the corresponding groups given TPN with MAA, except for the mean concentrations of some urea-cycle amino acids such as citrulline and ornithine, and glycine in the serum. The mean concentration of arginine in serum of the TPN with EAA groups was not lower than that of the corresponding groups given TPN with MAA and the control group. The mean serum level of other amino acids in the urea cycle such as ornithine or citrulline, was lower in the groups given TPN with EAA than that of groups given TPN with MAA and the control group, specially the three-day group. It was concluded that TPN using EAA exclusively as the source of nitrogen resulted in hyperammonemia. The deficiency of arginine in the formula failed to account for the hyperammonemia observed. Deficiencies of citrulline and ornithine resulting from inhibition of arginosuccinate synthetase may play a part, but the mechanism may be much more complicated. EAAs are to be avoided as the only source of nitrogen when TPN is indicated and if their use is necessary, the serum ammonia level should be tested frequently. If the level remains elevated or if toxicity develops, consideration should be given to an alternative fluid. |
| 關鍵詞 |
total parenteral nutrition, essential amino acid, urea cycle, mixed amino acids, hyperammonemia. |
| 分類 |
Original Article |
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