Determinants of skeletal muscle catabolism after severe burn
Determinants of skeletal muscle catabolism after severe burn
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DOI：
10.1097/00000658-200010000-00001
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发表时间：
2000-10-01
影响因子：
9
通讯作者：
Herndon, DN
中科院分区：
文献类型：
--
作者：
Hart, DW;Wolf, SE;Herndon, DN
目的确定哪些患者因素影响严重烧伤后catalysts的程度。摘要背景资料catalysts与严重烧伤，并导致侵蚀瘦体重，伤口愈合受损，延迟康复。在102名儿童和21名成人受试者中进行了151项稳定同位素蛋白动力学研究，烧伤面积超过其总体表面积（TBSA）的20-99.5%。患者的人口统计学资料、烧伤特征和住院过程变量与整个腿部骨骼肌蛋白质合成和分解的净平衡相关。通过单变量和横断面多元回归分析数据，结果年龄、体重的增加和最终手术治疗的延迟预测catabolism的增加（P <0.05）。体表面积烧伤增加catalysts，直到达到40%TBSA; catalysts并没有持续增加之后。静息能量消耗和脓毒症也是净蛋白质代谢的强预测因子。与烧伤类型、肺炎、伤口污染和烧伤后时间无显著相关性的因素。从这些结果中，作者还推断，总肌肉质量独立与蛋白质浪费后burn.Conclusions较重，更肌肉的科目，并最终的手术治疗延迟的科目是在最大的风险烧伤后过量catalysts。脓毒症和过度高代谢也与蛋白质催化剂有关。
Objective To determine which patient factors affect the degree of catabolism after severe burn.Summary Background Data Catabolism is associated with severe burn and leads to erosion of lean mass, impaired wound healing, and delayed rehabilitation.Methods From 1996 to 1999, 151 stable-isotope protein kinetic studies were performed in 102 pediatric and 21 adult subjects burned over 20-99.5% of their total body surface area (TBSA). Patient demographics, burn characteristics, and hospital course variables were correlated with the net balance of skeletal muscle protein synthesis and breakdown across the leg. Data were analyzed sequentially and cumulatively through univariate and cross-sectional multiple regression.Results Increasing age, weight, and delay in definitive surgical treatment predict increased catabolism (P < .05). Body surface area burned increased catabolism until 40% TBSA was reached; catabolism did not consistently increase thereafter. Resting energy expenditure and sepsis were also strong predictors of net protein catabolism. Among factors that did not significantly correlate were burn type, pneumonia, wound contamination, and time after burn. From these results, the authors also infer that gross muscle mass correlates independently with protein wasting after burn.Conclusions Heavier, more muscular subjects, and subjects whose definitive surgical treatment is delayed are at the greatest risk for excess catabolism after burn. Sepsis and excessive hypermetabolism are also associated with protein catabolism.