Metabolic abnormalities associated with postoperative organ failure. A redox theory.
Metabolic abnormalities associated with postoperative organ failure. A redox theory.
复制标题
与术后器官衰竭相关的代谢异常。
作者：
K. Ozawa;H. Aoyama;K. Yasuda;Y. Shimahara;T. Nakatani;J. Tanaka;M. Yamamoto;Y. Kamiyama;T. Tobe
我们研究了55例术后器官衰竭患者的代谢异常，并根据术后动脉血酮体比值的变化将其分为四组（乙酰乙酸-β-羟基丁酸）反映肝线粒体氧化还原电位：A组患者未降至0.7以下，B组患者一过性降至0.4，C组患者逐渐下降至0.4以下，D组（终末期）患者下降至0.25以下。A、B组患者均耐受良好，C、D组患者出现多器官功能衰竭。在B、C和D组中，丙氨酸、脯氨酸、苯丙氨酸和酪氨酸的血浆浓度与血酮体比呈负相关，支链氨基酸和芳香族氨基酸的血浆浓度之间的摩尔比与血酮体比呈正相关。肝脏能量不足伴血酮体比值降低可能是术后器官衰竭的代谢基础。
We studied metabolic abnormalities of postoperative organ failure in 55 patients and classified them into four groups according to the postoperative changes in the arterial blood-ketone body ratio (acetoacetic acid-beta-hydroxybutyric acid) reflecting hepatic mitochondrial redox potential: patients in group A had no decrease below 0.7, patients in group B had a transient decrease to 0.4, patients in group C had a progressive decrease to below 0.4, and patients in group D (terminal stage) had a decrease to below 0.25. All group A and B patients tolerated their operations well; the group C and D patients had multiple organ failure. In groups B, C, and D, plasma concentrations of alanine, proline, phenylalanine, and tyrosine were negatively correlated with the blood--ketone body ratio and the molar ratios between the plasma concentrations of branched-chain amino acids and aromatic amino acids were positively correlated with the blood--ketone body ratio. Hepatic energy deficit associated with decreasing blood-ketone body ratio may be the metabolic basis of postoperative organ failure.