The low‐dose monoethylglycinexylidide test: Assessment of liver function with fewer side effects
The low‐dose monoethylglycinexylidide test: Assessment of liver function with fewer side effects
复制标题
DOI：
10.1002/hep.510250603
复制
发表时间：
1997-06
期刊：
影响因子：
13.5
通讯作者：
C. Reichel;A. Nacke;T. Sudhop;G. Wienkoop;C. Luers;C. Hahn;C. Pohl;U. Spengler;T. Sauerbruch
中科院分区：
文献类型：
--
作者：
C. Reichel;A. Nacke;T. Sudhop;G. Wienkoop;C. Luers;C. Hahn;C. Pohl;U. Spengler;T. Sauerbruch
利多卡因（1 mg/kg静脉注射）在肝脏代谢为代谢产物单乙基甘氨酰二甲苯胺（MEG-X）是标准MEG-X试验的基础。为了减少利多卡因诱导的副作用，我们在肝功能正常（n = 5）和严重受损（n = 7）的受试者中评价了静脉注射0.5和1 mg/kg利多卡因后的MEG-X形成（研究I）。根据本研究，开发了低剂量试验（静脉注射50 mg利多卡因后30分钟的MEG-X浓度[MEG-X30分钟]，标准化为标准MEG-X试验结果）。在一项双盲、随机、交叉研究（研究II）中比较了低剂量和标准MEG-X测试的感觉副作用，该研究包括15名肝功能正常的个体和45名肝硬化患者（15名儿童A，15名儿童B和15名儿童C）。在研究I中，在肝功能严重受损的患者中，MEG-X形成率与剂量无关。在研究II中，标准化MEG-X测试结果（范围从≤ 4 μg/L到120 μg/L）与标准测试结果几乎相同（平均差异：-1.9 μg/L; 95%置信区间[CI]：-5.3; 1.5 μg/L）。低剂量试验中出现副作用的个体较少（30% vs. 53%）（P = .0013）。在多变量分析中，Child-Pugh评分与副作用的发生呈负相关。低剂量MEG-X测试提供了几乎相同的结果，标准MEG-X测试，并与较少的副作用，这发生在个人更严重的肝功能损害较少。
The hepatic metabolism of lidocaine (1 mg/kg intravenously) to its metabolite monoethylglycinexylidide (MEG‐X) is the basis of the standard MEG‐X test. To reduce the lidocaine‐induced side effects, we evaluated the MEG‐X formation after 0.5 and 1 mg/kg lidocaine intravenously in subjects with normal (n = 5) and severely impaired liver function (n = 7) (study I). From this study, a low‐dose test (MEG‐ X concentration 30 minutes after 50 mg lidocaine intravenously [MEG‐ X30min] normalized to standard MEG‐X test results) was developed. Sensory side effects from this low dose and from the standard MEG‐X test were compared in a double‐blind, randomized, cross‐over study (study II) comprising 15 individuals with normal liver function and 45 patients with cirrhosis (15 Child A, 15 Child B, and 15 Child C). In study I, MEG‐X formation rate was dose‐independent in patients with severely impaired liver function. In study II, normalized MEG‐X test results (ranging from < or = 4 to 120 μg/L) were virtually identical to the standard test results (mean difference: ‐1.9 μg/L; 95% confidence interval [CI]: ‐5.3; 1.5 μg/L). Fewer individuals experienced side effects (30% vs. 53%) with the low‐dose test (P = .0013). In a multivariate analysis, the Child‐Pugh score was inversely related to the occurrence of side effects. The low‐dose MEG‐X test gives almost identical results to the standard MEG‐X test and is associated with fewer side effects, which occur less often in individuals with more severely compromised liver function.