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氧化还原耐受性测试在评估脂肪肝中的效用。

Usefulness of redox tolerance test in evaluating fatty liver.

作者信息

Totsuka E, Itoh S, Shindo K, Suzuki K, Matsuura K, Nozaki T, Takiguchi M, Narumi S, Hakamada K, Endoh M, Sasaki M

机构信息

Second Department of Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.

出版信息

Hepatogastroenterology. 2001 Jan-Feb;48(37):184-7.

Abstract

BACKGROUND/AIMS: In living-related liver transplantation, fatty liver should be exactly detected in the healthy donor with noninvasive measurement before the surgery. The study aimed to investigate the usefulness of redox tolerance test in diagnosing fatty liver.

METHODOLOGY

The subjects were 32 patients who underwent an abdominal surgery. They did not show any abnormal values in biochemical evaluations, nor had they diabetes. Under informed consent, liver specimens were obtained intraoperatively, and the subjects were divided into three groups according to the degree of hepatic fatty deposit: group A has fatty deposits at less than 10% of hepatocytes (n = 12), group B showed the deposits at 10-30% (n = 10), group C has the deposits of more than 30% (n = 10). Before the surgery, redox tolerance test was performed as follows; arterial blood samples were obtained successively at 75 g oral glucose load over a 120-min period, and the arterial ketone body ratio and blood glucose level were determined. The ratio of increased arterial ketone body ratio (AKBR) to increased blood glucose (BG) level (100 x delta AKBR/delta BG) was calculated as redox tolerance index.

RESULTS

After fasting state, arterial ketone body ratio and blood glucose level did not differ among the three groups. However, the values of redox tolerance index in groups B (0.73 +/- 0.08) and C (0.46 +/- 0.04) were significantly lower than those in group A (1.85 +/- 0.31).

CONCLUSIONS

The redox tolerance test was exceedingly sensitive indicator for objectively diagnosing the fatty liver.

摘要

背景/目的:在活体肝移植中,术前应通过无创检测准确诊断健康供体的脂肪肝。本研究旨在探讨氧化还原耐受试验在诊断脂肪肝中的应用价值。

方法

研究对象为32例行腹部手术的患者。他们在生化评估中未显示任何异常值,也无糖尿病。在获得知情同意后,术中获取肝组织标本,并根据肝脂肪沉积程度将受试者分为三组:A组肝细胞脂肪沉积小于10%(n = 12),B组显示沉积为10 - 30%(n = 10),C组沉积超过30%(n = 10)。手术前,氧化还原耐受试验按以下方式进行;在120分钟内口服75克葡萄糖后连续采集动脉血样本,并测定动脉酮体比值和血糖水平。计算动脉酮体比值增加量(AKBR)与血糖增加量(BG)的比值(100×ΔAKBR/ΔBG)作为氧化还原耐受指数。

结果

空腹状态下,三组的动脉酮体比值和血糖水平无差异。然而,B组(0.73±0.08)和C组(0.46±0.04)的氧化还原耐受指数值显著低于A组(1.85±0.31)。

结论

氧化还原耐受试验是客观诊断脂肪肝的极其敏感的指标。

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