PROLONGATION OF THE HALF-LIFE OF LACTATE AFTER MAXIMAL EXERCISE IN PATIENTS WITH HEPATIC-DYSFUNCTION
PROLONGATION OF THE HALF-LIFE OF LACTATE AFTER MAXIMAL EXERCISE IN PATIENTS WITH HEPATIC-DYSFUNCTION
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DOI：
10.1097/00003246-198909000-00004
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发表时间：
1989-09-01
影响因子：
8.8
通讯作者：
RACKOW, EC
中科院分区：
文献类型：
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作者：
ALMENOFF, PL;LEAVY, J;RACKOW, EC
先前已在肝功能障碍患者中证实外源性乳酸钠的肝脏清除率降低。本研究的目的是获得一个更准确的了解率代谢正常化或减少内源性产生的乳酸在肝硬化患者。乳酸代谢的微分动力学具有临床意义。将急性住院存活的肝硬化男性志愿者患者（n = 7）与肝功能正常的健康年龄匹配男性（n = 7）进行比较。动脉插管后，在25瓦（W）的工作负荷下进行自行车测力计;以2分钟的间隔增加25 W的负荷至最大有氧能力。在运动前、运动中每隔4分钟和运动后30至70分钟内至少11次测量动脉血中的乳酸盐。以图形方式计算乳酸盐线性下降至其最大浓度一半（Lt 50）的时间间隔。LT 50为34.8 ±。4.5 min（平均值±）SEM）和14.1 . ±. 1.3在对照组中为min（p <0.005）。在肝硬化患者中，乳酸盐从血液中消失的速度几乎慢三倍。解释乳酸的变化在循环休克过程中肝功能障碍的存在的含义是解决。
Decreased hepatic clearance of exogenous sodium lactate has previously been demonstrated in patients with hepatic dysfunction. The purpose of this study was to obtain a more precise understanding of the rate of metabolic normalization or decrease of endogenously produced lactate in patients with hepatic cirrhosis. The differential kinetics of lactate metabolism are of clinical interest. Male volunteer patients with hepatic cirrhosis (n = 7), who had survived acute hospitalization, were compared to healthy age-matched males with normal liver function (n = 7). After arterial cannulation, bicycle ergometry was performed at a workload of 25 watts (W); the load was increased by increments of 25 W at 2-min intervals to maximum aerobic capacity. Lactate was measured in arterial blood before, at 4-min intervals during, and on a minimum of 11 occasions in the 30 to 70 min after exercise. The time interval during which lactate declined linearly to half its maximal concentration (Lt50) was graphically computed. The Lt50 was 34.8 .+-. 4.5 min (mean .+-. SEM) in the experimental group and 14.1 .+-. 1.3 min in the control subjects (p < .005). Lactate disappears from the bloodstream almost three times more slowly in patients with hepatic cirrhosis. The implication for interpretation of changes in lactate during circulatory shock in the presence of liver dysfunction is addressed.