Monoethylglycinexylidide Formation Kinetics: A Novel Approach to Assessment of Liver Function
Monoethylglycinexylidide Formation Kinetics: A Novel Approach to Assessment of Liver Function
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单乙基甘氨酰二胺形成动力学：一种评估肝功能的新方法
DOI：
10.1515/cclm.1987.25.12.845
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
C. Wittekind
中科院分区：
文献类型：
--
作者：
M. Oellerich;E. Raude;M. Burdelski;M. Schulz;F. Schmidt;B. Ringe;P. Lamesch;R. Pichlmayr;H. Raith;M. Scheruhn;M. Wrenger;C. Wittekind
描述了一种新颖的定量肝功能测试，其基于利多卡因推注后单乙基甘氨酰二胺 (MEGX) 的形成。在健康志愿者、肝脏捐献者和肝硬化患者中，使用小剂量单剂量盐酸利多卡因（1 mg/kg）后，通过新型高灵敏荧光偏振免疫分析（FPIA）测定单乙基甘氨酰二胺血清浓度-时间曲线。 FPIA 可快速、可靠地测定血清和尿液中的单乙基甘氨酰二胺（日间变异系数：小于 10.3%，回收率：80-113%）。通过 FPIA 测量的 32 份患者血清样本中的单乙基甘氨酰二甲苯胺浓度与通过 HPLC 测定的浓度有很好的相关性。利多卡因推注后 15 分钟测定的血清中单乙基甘氨酰二胺浓度被证明是肝功能障碍的高度敏感和特异性指标。注射利多卡因 15 分钟后，肝硬化患者血清中单乙基甘氨酰二胺的平均浓度显着低于健康志愿者。与没有相关肝脏组织学改变的供体相比，具有肝细胞膨胀或脂肪变化的肝脏供体中血清中的平均单乙基甘氨酸二甲苯浓度也显着降低。通过在供肝者体内形成单乙基甘氨酰二胺，正确预测了 32/37 例移植肝脏的主要功能，4/6 例预测了最初的无功能。
A novel quantitative liver function test is described which is based on monoethylglycinexylidide (MEGX) formation after lidocaine bolus injection. Following the administration of small single doses of lidocaine hydrochloride (1 mg/kg), monoethylglycinexylidide serum concentration-time curves were determined by a novel highly sensitive fluorescence polarisation immunoassay (FPIA) in healthy volunteers, liver donors and patients with liver cirrhosis. The FPIA allowed rapid and reliable monoethylglycinexylidide determinations in serum and urine (between-days coefficient of variation: less than 10.3%, recovery: 80-113%). Monoethylglycinexylidide concentrations measured by FPIA in 32 serum samples from patients correlated well those determined by HPLC. The monoethylglycinexylidide concentration in serum determined 15 min after a lidocaine bolus injection proved to be a highly sensitive and specific indicator of hepatic dysfunction. Average monoethylglycinexylidide concentrations in serum obtained 15 min after lidocaine injection were substantially lower in patients with liver cirrhosis than in healthy volunteers. The average monoethylglycinexylidide concentrations in serum were also substantially lower in liver donors with ballooning or fatty changes of hepatocytes than in donors without relevant alterations of liver histology. By means of monoethylglycinexylidide formation in the liver donors, primary function of the transplanted liver was correctly predicted in 32/37 cases and initial non-function in 4/6 cases.