Reduced serum amino acid concentrations in infants with necrotizing enterocolitis
Reduced serum amino acid concentrations in infants with necrotizing enterocolitis
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DOI：
10.1067/mpd.2000.109145
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发表时间：
2000-12-01
影响因子：
5.1
通讯作者：
Rhoads, JM
中科院分区：
文献类型：
--
作者：
Becker, RM;Wu, GY;Rhoads, JM
目的：确定患有坏死性小肠结肠炎（NEC）的早产儿是否缺乏对肠道完整性至关重要的谷氨酰胺（GLN）和精氨酸（ARC）。 研究设计：对早产儿血清氨基酸和尿素水平进行了为期 4 个月的前瞻性队列研究。分别采用高压液相色谱法和酶法测定出生后第 3、7、14 和 21 天采集的样本的血清氨基酸和尿素水平。结果：对照组 (n = 32) 和 NEC 组 (n = 13) 的婴儿在出生体重、胎龄和 Apgar 评分方面具有可比性。 NEC 于平均出生日 14.5 日开始（95% CI，出生日 11 至 18 天）。与对照组相比，NEC 组在第 7、14 和 21 天的 GLN 中位值降低了 37% 至 57% (P < .05)。第 7 天和第 14 天，NEC 组中 ARC、GLN、丙氨酸、赖氨酸、鸟氨酸和苏氨酸的中位值下降了 36% 至 67% (P < .05)。第 7 天和第 14 天，NEC 组的总非必需氨基酸和总必需氨基酸降低了 35% 至 50% (P < .05)。 NEC 组婴儿在 NEC 发病前 7 天，GLN 和 ARG 显着降低。结论：患有 NEC 的婴儿存在选择性氨基酸缺乏，包括 GLN 和 ARG 水平降低，可能诱发该病。
Objective: To determine whether premature infants who have necrotizing enterocolitis (NEC) have deficiencies in glutamine (GLN) and arginine (ARC), which are essential to intestinal integrity.Study design: A 4-month prospective cohort study of serum amino acid and urea levels in premature infants was done. Serum amino acid and urea levels were measured by high-pressure liquid chromatography and enzymatic ic methods, respectively, on samples obtained on days of life 3, 7, 14, and 21.Results: Infants in the control (n = 32) and NEC groups (n = 13) were comparable for birth weight, gestational age, and Apgar scores. NEC began on mean day of life 14.5 (95% CI, day of life 11 to 18). Median values of GLN were 37% to 57% lower in the NEC group on days 7, 14, and 21 compared with those in the control group (P < .05). On days 7 and 14, median values of ARC, GLN, alanine, lysine, ornithine, and threonine were decreased 36% to 67% (P < .05) in the NEC group. Total nonessential amino and total essential amino acids were 35% to 50% lower in the NEC group on days 7 and 14 (P < .05). Infants in the NEC group had significant reductions in GLN and ARG 7 days before the onset of NEC.Conclusions: infants who have NEC have selective amino acid deficiencies including reduced levels of GLN and ARG that may predispose to the illness.