カワシマ　アキツグ   Kawashima Akitsugu   川島　明次    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	原著
言語種別	日本語
査読の有無	査読あり
表題	Metabolic profiles of patients with subarachnoid hemorrhage treated by early surgery.
掲載誌名	正式名：Neurosurgery 略　 称：Neurosurgery ISSNコード：0148396X/0148396X
掲載区分	国外
巻・号・頁	42(6),1268-74; discussion 1274-5頁
著者・共著者	Kasuya H, Kawashima A, Namiki K, Shimizu T, Takakura K
担当区分	2nd著者
発行年月	1998/06
概要	OBJECTIVE:This study was conducted to evaluate the metabolic response of patients with subarachnoid hemorrhage (SAH) and to determine whether the severity of hemorrhage influenced the response.METHODS:Resting energy expenditure, nitrogen balance, and serum rapid-turnover proteins were studied for 3-day periods at Day 4, Day 10, and before discharge in patients with SAH who underwent surgical clipping within 2 days after the onset. The patients were divided into two groups according to the Hunt and Hess classification system; there were 17 patients with Grade I or II (mild group) and 19 patients with Grade III, IV, or V (severe group).RESULTS:The mean resting energy expenditures (mean+/-standard deviation) were highest on Day 10, which were 146+/-24% and 198+/-78% of basal energy expenditure in the mild and severe groups, respectively. The nitrogen balance levels of the mild group on Days 4 and 10 were -3.0+/-3.5 g per day and -4.5+/-2.9 g per day, and those of the severe group were -7.5+/-3.2 g per day and -9.2+/-4.1 g per day, respectively. There was a significant difference in the nitrogen balance over time between the two groups (P=0.0037). Serum transferrin, prealbumin, and retinol-binding protein levels were lowest on Day 4 and gradually increased. There were no significant differences in these parameters between the two groups.CONCLUSION:SAH treated by surgery induces a profound stress response. A significant difference of increased catabolism but not decreased anabolism between the mild and severe groups was noted.
DOI	10.1097/00006123-199806000-00038
PMID	9632184