Woll P J, Record C O
Eur J Clin Invest. 1979 Oct;9(5):397-404. doi: 10.1111/j.1365-2362.1979.tb00903.x.
Lactate elimination was studied in twenty-six healthy volunteers during primed constant lactate infusion or multiple lactate injection tests, at blood lactate concentrations of 1-8 mmol-1. Although lactate elimination fitted a single exponential curve over a 30 min period, a significant correlation between the rate removal constant (KL) and the peak blood lactate concentration (Lphi) was demonstrated: loge KL = -2.43-0.132 Lphi (P = 0.003, r = 0.63, n = 20) This suggests that lactate removal does not follow first order kinetics over a wide concentration range but becomes saturated at relatively low blood lactate concentrations. Estimates of the lactate distribution volume did not differ significantly at different dosage levels, but remained in the range 270-300 ml kg-1. Skeletal muscle uptake accounted for about 26% of the infused lactate load. Seven patients with well-compensated hepatic cirrhosis were compared with a group of six control subjects during primed constant infusion tests. Fasting and steady state blood lactate concentrations achieved were similar in both groups. A significant prolongation in lactate half-life was demonstrated in the cirrhotics (18.8 +/- 1.4 min (mean +/- SEM) compared to 14.7 +/- 2.2 min; P less than 0.02). Since peripheral uptake of lactate in the forearm was similar in the two groups, this suggests that hepatic lactate uptake was impaired, due either to hepatocyte dysfunction or portal diversion.
在26名健康志愿者中，于血乳酸浓度为1 - 8 mmol⁻¹时，通过预充恒速乳酸输注或多次乳酸注射试验研究了乳酸清除情况。尽管在30分钟内乳酸清除符合单指数曲线，但速率清除常数（KL）与血乳酸峰值浓度（Lphi）之间存在显著相关性：ln KL = -2.43 - 0.132 Lphi（P = 0.003，r = 0.63，n = 20）。这表明在较宽的浓度范围内，乳酸清除并不遵循一级动力学，而是在相对较低的血乳酸浓度时达到饱和。不同剂量水平下乳酸分布容积的估计值无显著差异，仍在270 - 300 ml·kg⁻¹范围内。骨骼肌摄取约占输注乳酸负荷的26%。在预充恒速输注试验期间，将7例代偿良好的肝硬化患者与6名对照受试者组成的一组进行了比较。两组达到的空腹和稳态血乳酸浓度相似。肝硬化患者的乳酸半衰期显著延长（18.8 ± 1.4分钟（均值 ± 标准误），而对照组为14.7 ± 2.2分钟；P < 0.02）。由于两组前臂乳酸的外周摄取相似，这表明肝摄取乳酸受损，原因可能是肝细胞功能障碍或门体分流。
