劉金華 NO NO T arginine arginase ornithine ornithine polyamine 2 Polyamine 3 arginine arginine 4 glutamine 5 glutamine glutamine 6 Beta-hydroxy-beta-me

Size: px

Start display at page:

Download "劉金華 NO NO T arginine arginase ornithine ornithine polyamine 2 Polyamine 3 arginine arginine 4 glutamine 5 glutamine glutamine 6 Beta-hydroxy-beta-me"

盐侑容
7 years ago
Views:

1 個案報告特殊混合胺基酸用於輔助化學性燒燙傷之傷口癒合 , 摘要 arginine glutamine Beta-hydroxy-beta-methylbutyrate HMB % 23 6 cm kcal 101% 146 g 94.2% 15 arginine glutamine HMB 23 6 cm 14 7 cm 63.5 kg 64 kg arginine glutamine HMB Beta-hydroxy-beta-methyl butyrate HMB 前言 1 arginine NO synthase tmu0217@adml.cgmh.org.tw TJD 2011;3(1):53-58 Taiwan Journal of Dietetics

2% 15 arginine glutamine HMB 23 6 cm 14 7 cm 63.

2 劉金華 NO NO T arginine arginase ornithine ornithine polyamine 2 Polyamine 3 arginine arginine 4 glutamine 5 glutamine glutamine 6 Beta-hydroxy-beta-methylbutyrate HMB leucine 7 8 arginine glutamine HMB 個案簡介 cm 63.5 kg BMI 22.6 kg/m % 23 6 cm cm 2 sulfasil cream staphylococcus tangential excision sulfasil cream tangential excision mepilex-ag 營養照護 ( ) GFR estimated (ml/m/1.7m 2 ) >60 MCV (fl) 92.8 BUN (mg/dl) 9 MCH (pg/cell) 32.4 Creatinine (mg/dl) 0.94 MCHC (ghb/dl) 34.9 AST/GOT (U/L) 29 RDW (1000/uL) 11.3 Na (meq/l) Platelets (%) 277 K (meq/l) 3.97 Segment (%) 53.6 WBC (1000/uL) 5.8 Lymphocyte (%) 43.1 RBC (million) 4.69 Monocyte (%) 2.7 Hemoglobin (g/dl) 15.2 Eosinophil (%) 0.3 Hematocrit (%) 43.5 Basophil (%)

6 kg/m 2 2011 2 24 200 2-3 3% 23 6 cm 2 6 2 cm 2 sulfasil cream staphylococcus 2011 3 1 tangential excision sulfasil cream 2011 3 8 tangential excision mepilex-ag 2011 3 21 營養照護 2011 2 25 ( ) GFR

3 特殊混合胺基酸用於化學性燒燙傷之傷口癒合 kcal/day daily calorie intake daily protein intake body weight (kg) Date g/day Long s modified the Harris-Benedict equation [ 66+ ( 13.7 BW+ ( 5 BH )-( 6.8 age ) 1.3 ( ) 1.4 ( )] 2800 kcal/day 155 g/day ( 2.5 g/kg BW ) 2839 kcal/day ( kcal/ day) ( ) 146 g/day ( g/day ) pc/day ( HMB 1.2 g/pc glutamine 7 g/ pc arginine 7 g/pc 15 ) cm cm kg 64 kg 討論 catecholamines glucocorticoids glucagon kcal/kg/day kcal / day 9 basal metabolic rate, BMR Long s modified the Harris- Benedict equation 2800 kcal/day 44 kcal/kg/ day BMR kcal/day kcal/day 101%. 55.

7 BW+ ( 5 BH )-( 6.8 age ) 1.3 ( ) 1.4 ( )] 2800 kcal/day 155 g/day ( 2.5 g/kg BW ) 2839 kcal/day ( 1350-3250 kcal/ day) ( ) 146 g/day ( 75-188 g/day ) 100 3 5 3 19 2 pc/day ( HMB 1.

4 劉金華 ( 23 6 cm 2 ) ( cm 2 ) ( 18 7 cm 2 ) ( 18 7 cm 2 ) ( 14 7 cm 2 ) RNA DNA g/day 2.5 g/kg BW 146 g/day g/day 94.2% 2-3 g/kg BW/ day 15-25% 9 Masters 20% C3 IgA g/kg/day 40.8 kcal/ kg/day 1.4 g/kg/ day 40.8 kcal/kg/day kcal/kg/day protein hydrolysate 70 g/day g/kg/day g/kg/day kg 64 kg 3 g/kg BW/day 25% 9,13, % 10 glucose insulin 9-3 omega-3 fatty acid 12,15

2 g/kg/day 40.8 kcal/ kg/day 1.4 g/kg/ day 40.8 kcal/kg/day 13 30-35 kcal/kg/day protein hydrolysate 70 g/day 1.7-2 g/kg/day 1.

5 特殊混合胺基酸用於化學性燒燙傷之傷口癒合 9 16 immunonutrients glutamine arginine -3 omega-3 fatty acid nucleotide glycine 9 Peng glutamine granules 0.5 g/kg/day glutamine 17 arginine 2002 arginine 18 Kirk >65 17 g/day arginine HMB HMB 7,19 Williams 2002 >70 arginine 14 g/ day glutamine 14 g/day HMB 3 g/day arginine ornithine 19 結論 HMB 4.8 g/day glutamine 14 g/day arginine 14 g/day cm cm kg 64 kg 參考文獻 1. Katona P, Katona-Apte J. The Interaction between Nutrition and Infection. Clin Infect Dis 2008;46: Field CJ, Johnson I, Pratt VC. Glutamine and arginine: immunonutrients for improved health. Med sci sports exerc 2000;32 (7 Suppl):S377-S Knowles RG, Palacios M, Palmer RMJ, Moncada S. Formation of nitric oxide from L-arginine in the central nervous system: A transduction mechanism for stimulation of the soluble guanylate cyclase. Proc Natl Acad Sci U. S. A 1989;86: Welters CFM, Dejong CHC, Deutz NEP, Heineman E. Effects of parenteral arginine supplementation on the intestinal adaptive response after massive small bowel resection in the rat. J surg res 1999;85: ,. 5. Lacey JM, Crouch JB, Benfell K, Ringer SA, Wilmore CK, Maguire D, Wilmore DW. The effects of glutaminesupplemented parenteral nutrition in premature infants. J parenter enteral nutr 1996;20: Kapadia CR, Muhlbacher F, Smith RJ, Wilmore DW. Alternations in glutamine. 57.

HMB 4.8 g/day glutamine 14 g/day arginine 14 g/day 15 23 6 cm 2 14 7 cm 2 63.5 kg 64 kg 參考文獻 1. Katona P, Katona-Apte J. The Interaction between Nutrition and Infection.

6 劉金華 metabolism in response to operative stress and food deprivation. Surg forum 1982;33: Smith HJ, Muker ji P, Tisdale MJ. Attenuation of proteasome-induced proteolysis in skeletal muscle by betahydroxy-beta-methylbutyrate in cancerinduced muscle loss. Cancer research 2005;65: Nissen S, Sharp R, Ray M, Rathmacher JA, Rice D, Fuller JC, Connelly JAS, Abumrad N. Effect of leucine metabolite -hydroxy- -methylbutyrate on muscle metabolism during resistance-exercise training. J Appl Physiol 1996;81: Masters B, Wood F. Nutrition support in burns--is there consistency in practice? J Burn Care Res 2008;29(4): Demling RH, DeSanti L. Increased protein intake during the recovery phase after severe burns increases body weight gain and muscle function. J Burn Care Rehabil 1998;19(2): Brown KL, Phillips TJ. Nutrition and wound healing. Clin Dermatol 2010;28(4): Wild T, Rahbarnia A, Kellner M, Sobotka L, Eberlein T. Basics in nutrition and wound healing. Nutrition 2010;26(9): Wolfe RR, Goodenough RD, Burke JF, Wolfe MH. Response of protein and urea kinetics in burn patients to different levels of protein intake. Ann Surg 1983;197(2): Wolfe RR. Herman award lecture, 1996: relation of metabolic studies to clinical nutrition-the example of burn injury. Am J Clin Nutr 1996;64: Kirk SJ, M, Reg an MC, Holt DR, Wasserkrug HL, Barbul A. Arginine stimulates wound healing and immune function in elderly human beings. Surgery 1993;114(2): Posthauer ME, Dorner B, Collins N. Nutrition: a critical component of wound healing. Adv Skin Wound Care 2010;23(12): Peng X, Yan H, You Z, Wang P, Wang S. Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients. Burns 2006;32(5): Tsai HJ, Shang HF, Yeh CL, Yeh SL. Effects of arginine supplementation on antioxidant enzyme activity and macrophage response in burned mice. Burns 2002;28: Williams JZ, Abumrad N, Barbul A. Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg 2002;236(3):

Nissen S, Sharp R, Ray M, Rathmacher JA, Rice D, Fuller JC, Connelly JAS, Abumrad N. Effect of leucine metabolite -hydroxy- -methylbutyrate on muscle metabolism during resistance-exercise training.

戴珊如 BUN Cr GFR Na mmol/l K mmol/l P mg/l Ca Hb Ht % UA Alb g/dl TC TG 28 8 30 102 7.5 6.7 138 4.7 8 6 16.7 28 9 1 83 7.2 7 4.2 6.9 7.2 13 3.9 368 33

戴珊如 BUN Cr GFR Na mmol/l K mmol/l P mg/l Ca Hb Ht % UA Alb g/dl TC TG 28 8 30 102 7.5 6.7 138 4.7 8 6 16.7 28 9 1 83 7.2 7 4.2 6.9 7.2 13 3.9 368 33 個案報告血液透析孕婦之營養照護經驗摘要慢性腎臟病 chronic kidney disease, CKD 患者懷孕是罕見的病例增加每週的透析時間且整合多科治療可提高懷孕成功的機會一位 32 歲 CKD 女性於懷孕 28 週時住院並開始接受每週 4 次的

劉 金 華 NO NO T arginine arginase ornithine ornithine polyamine 2 Polyamine 3 arginine arginine 4 glutamine 5 glutamine glutamine 6 Beta-hydroxy-beta-me

劉金華 NO NO T arginine arginase ornithine ornithine polyamine 2 Polyamine 3 arginine arginine 4 glutamine 5 glutamine glutamine 6 Beta-hydroxy-beta-me