Response of Hepatic Mitochondrial Redox State to Oral Glucose Load: Redox Tolerance Test as a New Predictor of Surgical Risk in Hepatectomy
Response of Hepatic Mitochondrial Redox State to Oral Glucose Load: Redox Tolerance Test as a New Predictor of Surgical Risk in Hepatectomy
复制标题
肝线粒体氧化还原状态对口服葡萄糖负荷的反应：氧化还原耐受测试作为肝切除术手术风险的新预测因子
作者：
K. Mori;K. Ozawa;Y. Yamamoto;A. Maki;Y. Shimahara;N. Kobayashi;Y. Yamaoka;K. Kumada
本文介绍的氧化还原耐受试验试图通过测量口服75克葡萄糖负荷后动脉酮体比率的变化来量化肝线粒体能量代谢的恶化情况，并就其在评估肝切除手术风险中的预测价值进行了讨论。该指标称为氧化还原耐受指数（RTI），表示酮体比率相对于葡萄糖水平的100倍累积增强（100×ΔKBR/Δ葡萄糖）。31例肝硬化患者和10例正常志愿者之间的氧化还原耐受指数有显著差异（p<0.001）。受试者被分为三类（I类：RTI≥1.0；II类：0.5≤RTI<1.0；III类：RTI<0.5）。127例肝切除患者中，三类患者的术后死亡率有显著差异（χ² = 9.843，p<0.01）。在97例肝细胞癌病例中，III类患者的大肝切除术后发病率和死亡率显著更高（分别为p<0.05和p<0.05）。目前的研究结果表明，基于氧化还原理论的RTI在预测肝切除术后结果方面具有潜在价值。
The redox tolerance test introduced in this article attempts to quantify the deterioration of hepatic mitochondrial energy metabolism by measuring the changes in arterial ketone body ratio in response to 75-g oral glucose loading, and is discussed in relation to its predictive value for assessing surgical risk in hepatectomy. The indicator, called redox tolerance index (RTI), represents a 100-fold cumulative enhancement of ketone body ratio relative to glucose level (100 x delta KBR/delta glucose). The redox tolerance index was significantly different between 31 liver cirrhotics and 10 normal volunteers (p less than 0.001). Subjects were divided into three classes (I: RTI greater than or equal to 1.0, II: 0.5 less than or equal to RTI less than 1.0, III: RTI less than 0.5). Postoperative mortality was significantly different among the three classes in 127 hepatic resections (chi 2 = 9.843, p less than 0.01). Of 97 hepatocellular carcinoma cases, major hepatic resections in class III showed significantly higher postoperative morbidity and mortality rates (p less than 0.05 and p less than 0.05, respectively). The present findings indicate that RTI based on redox theory is of potential value in predicting posthepatectomy outcome.