Short-term changes in blood ketone body ratios in the phase immediately after hepatic artery embolization: their clinical significance.
Short-term changes in blood ketone body ratios in the phase immediately after hepatic artery embolization: their clinical significance.
复制标题
肝动脉栓塞后即刻阶段血酮体比值的短期变化：其临床意义。
DOI：
10.1097/00000441-198602000-00004
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
K. Ozawa
中科院分区：
文献类型：
--
作者：
T. Tani;Y. Taki;A. Jikko;S. Minematsu;M. Yamamoto;Y. Kamiyama;T. Tobe;K. Ozawa
本文观察了肝细胞癌患者经导管肝动脉栓塞术后动脉和肝静脉血酮小体的变化。动脉血和肝静脉血的乙酰乙酸酯/β-羟丁酸比值(酮体比值)呈正相关(r=0.960，p<0.001)，反映了栓塞叶线粒体的氧化还原电位。9例肝硬变患者根据TEA后动脉血酮体比值的变化分为3组：A型未降至0.7以下，B型短暂降至0.7以下，5h内恢复正常，C型降至0.7以下，5h内未恢复。A型和B型患者均未发生严重并发症。相比之下，C型患者出现严重的脓毒症和肝功能衰竭，可能是由于延长了双叶的栓塞期。提示，只要栓塞区局限于一个肺叶，即使是严重的肝硬变患者也可以成功地进行动脉栓塞术。此外，动脉血酮体比率的变化可以提供有关刚刚进行的TEA手术的可能后果的早期信息。
Changes in arterial and hepatic venous blood ketone bodies were investigated following transcatheter hepatic artery embolization (THAE) in patients with hepatocellular carcinoma. Acetoacetate/ beta-hydroxybutyrate ratio (ketone body ratio) in arterial blood was positively correlated with those of hepatic venous blood (r = 0.960, p less than 0.001), which reflects the mitochondrial redox potential in the embolized lobe. Nine cirrhotic patients were classified into three groups according to the changes in arterial blood ketone body ratio following THAE: Type A without decrease to below 0.7; Type B with a transient decrease to below 0.7, followed by its restoration within 5 hours; and Type C with decrease to below 0.7 without recovery within 5 hours. There were no serious complications in Type A and B patients. By contrast, severe sepsis and hepatic failure developed in Type C patients, possibly due to the extended embolization of both lobes. It is suggested that THAE can be successfully performed even in severely cirrhotic patients, as long as the embolized area is restricted to one lobe. In addition, changes in arterial blood ketone body ratios can give early information about the likely consequences of the THAE procedure just performed.