Lalazar Gadi, Adar Tomer, Ilan Yaron
Gastroenterology and Liver Units, Department of Medicine, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel.
World J Gastroenterol. 2009 Feb 28;15(8):966-72. doi: 10.3748/wjg.15.966.
To assess the role of the (13)C-methacetin breath test (MBT) in patients with acute liver disease.
Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with (13)C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores.
Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values.
The (13)C-MBT provides a rapid, non-invasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.
评估（13）C-美沙西汀呼气试验（MBT）在急性肝病患者中的作用。
对15例病因各异的重症急性肝病患者在疾病急性期（治疗后3 - 116天）进行（13）C-MBT随访。患者禁食8小时，在进行MBT前摄入75毫克美沙西汀。我们比较了标准临床评估、血清肝酶、合成功能和呼气试验评分的结果。
13例患者康复，2例患者死亡。在康复的患者中，MBT参数与实验室检查结果的改善同步改善。MBT参数在第3天开始持续改善，血液检查在第7天至第9天开始改善。MBT参数平均在9天恢复正常，血液检查在13天至28天恢复正常。在两名死亡患者中，尽管实验室值波动，但MBT参数仍保持较低水平。
（13）C-MBT为不同病因的急性重症肝病患者提供了一种快速、无创的肝功能评估方法。这项初步临床试验的结果表明，对于管理重症急性肝病患者，MBT可能比标准临床检查具有更高的敏感性。
