新生儿枫糖尿病在持续性体外静脉-静脉血迁移疗法期间血浆内亮氨酸水平的动态变化模型

作     者：Jouvet P. Hubert P. Saudubray J.M. 王经纬 

作者机构：Soins Intensifs Péd iatriques Hpital Sainte Justine 3175 chemin Cote Sainte Catherine Montr'ea l Que. H3T 1C5 Canada 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第1期

页      面：57-58页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：枫糖尿病 体外静脉 变化模型 持续性 参数模型 分布容积 治疗法 模型组 指数曲线 减少率 

摘      要：A kinetic modeling of leucine plasma concentration changes is proposed to desc ribe the plasma leucine reduction rate during continuous extracorporeal removal therapy (CECRT) in neonates with mapl e syrup urine disease. Data were obtained from seven neonates using a bicompartm ental model for the best fitted curve of plasma leucine decrease during CECRT. D uring the first 3 h, leucine plasma levels decreased according to an exponential curve: [Leu]t = [Leu]i ×0.95 ×10-0.09t where [Leu] t is the leucine plasma l evel (μmol/L) at time t (h) during CECRT and [Leu]i is the initial plasma level . From h 4 to the end of CECRT, a second exponential curve was observed: [Leu]t = [Leu]i ×0.74 ×10-0.05t. Plasma leucine levels obtained from three other neo nates were similar to those predicted by the model. The apparent distribution vo lumes for leucine that correspond to the two exponential equations obtained were calculated from the leucine mass removal collected in the spent dialysate and u ltrafiltrate. The distribution volume was 34 ±3%of body weight during the firs t 3 h of CECRT and 72 ±7%from h 4 to the end of CECRT. These figures are simil ar to known values for the extracellular water compartment and for total body wa ter in the newborn. The findings suggest that leucine handling during CECRT is s imilar to that of nonproteinbound small-molecular-weight solutes such as urea.