Trimethylamine and foetor hepaticus
Trimethylamine and foetor hepaticus
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DOI：
10.1080/003655299750026281
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发表时间：
1999-05-01
影响因子：
1.9
通讯作者：
Smith, R
中科院分区：
文献类型：
--
作者：
Mitchell, S;Ayesh, R;Smith, R
背景资料：在不同程度肝细胞衰竭和门体分流的患者中，呼吸可能会获得甜味、霉味或甚至轻微的粪便气味，称为肝粪味，这主要归因于挥发性硫化合物以及各种含氮物质的贡献。在这些患者中并不少见，也会遇到不寻常的体臭，通过与已知由过量三甲胺引起的“鱼臭综合征”类比，研究了后一种有毒性的胺可能导致与肝病相关的气味的可用性。研究方法：尿液（0-24小时）收集了63例患者的各种肝脏疾病，以前证实在医院的各种生化，免疫学，病理学和放射学研究。尿中总三甲胺和三甲胺N-氧化物水平测定与顶空气相色谱法。结果如下：总的来说，50%（63例中的32例）的患者（原发性肝病，47例中的25例，或53.2%;继发性肝病，16例中的7例，或43.8%）的尿三甲胺水平高于正常范围的上限（0.08-1.84 μ g/ml）。17名患者排出大量游离三甲胺（超过10 μ g/ml），高于通常与“鱼样”体臭和呼吸污染相关的阈值。结论：过量的三甲胺可能会导致严重肝病患者遇到的整体体臭问题，在这些个体中沉淀出继发性形式的“鱼臭综合征”。
Background: In patients with various degrees of hepatocellular failure and portosystemic shunting of blood the breath may acquire a sweet, musty, or even slightly faecal aroma, termed foetor hepaticus, which has been attributed mainly to volatile sulphur compounds with contributions from various nitrogenous substances. Not infrequently in such patients, unusual body odours are also encountered and, by analogy with the 'fish-odour syndrome' known to he caused by excessive trimethylamine, the availability of this latter graveolent amine to potentially contribute to odours associated with hepatic disease was investigated. Methods: Urine (0-24 h) was collected from 63 patients with various liver diseases previously confirmed in hospital by means of various biochemical, immunologic, pathologic, and radiologic investigations. Total trimethylamine and trimethylamine N-oxide levels in urine were measured with head-space gas chromatography. Results: In total, 50% (32 of 63) of the patients (primary liver disease, 25 of 47, or 53.2%; secondary Liver disease, 7 of 16, or 43.8%) had urinary trimethylamine levels greater than the upper end of the range considered normal (0.08-1.84 mu g/ml). Seventeen patients excreted large amounts of free trimethylamine (more than 10 mu g/ml), above the threshold usually associated with the appearance of a 'fish-like' body odour and tainted breath. Conclusions: Excessive amounts of trimethylamine may well contribute to the overall body odour problems encountered among patients with severe hepatic disease, precipitating in these individuals a secondary form of the 'fish-odour syndrome'.