血尿素和尿路尿素分泌的时间过程在长时间住院的ICU患者中
Hendrik W Zijlstra1,2,3,4, Gjalt J Westland5, Meint Volbeda5
1Department of Critical Care, University Medical Center Groningen, Groningen, The Netherlands. h.w.zijlstra@umcg.nl.
Scientific reports
|October 29, 2024
概括
尿液尿素分泌 (UUE) 和肌素分泌 (UCE) 在重症患者中追踪蛋白质分解和肌肉质量. 随着时间的推移,UUE和UCE的衰减,反映了长时间的重症监护室停留期间的肌肉损失和蛋白质代谢变化.
科学领域:
- 生物化学 生物化学
- 关键护理医学 关键护理医学
- 脏生理学 脏生理学
背景情况:
- 尿路肌酸分泌 (UCE) 是肌肉质量的标志物.
- 尿液尿素分泌 (UUE) 可能表明严重疾病中的蛋白质分解.
- 了解尿素处理对于管理重症患者至关重要.
研究的目的:
- 评估血尿素和肌素与UUE和UCE一起在长期住院的重症病患者中的血尿素和肌素的时间过程.
- 了解重症监护室 (ICU) 患者的尿素处理方法,通过分析血和尿尿尿素与肌素的比率 (UCR).
主要方法:
- 来自638名成人ICU患者的24小时尿液样本和血的分析,住院时间≥28天 (2002-2021年).
- 测量包括血尿素,血肌素,UUE和UCE.
- 计算了血和尿尿尿素与肌素的比率 (UCR);排除了患有第三阶段急性损伤 (AKI) 的患者.
- 分析按性别和功能分层 (有/没有急性功能衰竭).
主要成果:
- 血尿素在前10天增加 (9.7~12.4 mmol/L),然后下降.
- UUE在第13天左右达到峰值 (590 ± 317 mmol/day),而UCE在第4天更早达到峰值.
- 血和尿液的UCR在第7天后稳定,逐渐增加到第30天.
- 男性表现出比女性更高的血尿素,肌素,UUE和UCE.
结论:
- 血尿素和UUE的初始上升表明,在ICU入院的第一个星期,蛋白质代谢增加.
- 随后的UUE和UCE下降与典型的每日肌肉质量损失相关 (大约1. 1%) 在ICU患者中.
- 尿素和肌素分泌模式提供了对重症患者蛋白质代谢和肌肉质量变化的见解.
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