Mizobuchi N, Kuwao F, Takeda I, Takemura T, Morita S, Horimi T, Takahashi I
Department of Cancer Institute, Kochi Municipal Central Hospital.
Rinsho Byori. 1990 Jul;38(7):825-9.
The ketone body ratio (acetoacetate/3-hydroxybutyrate:KBR) and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma (HCC) were examined. KBRs and levels of pyruvate and lactate in patients with HCC were similar to those in patients without liver diseases (1.57 +/- 0.88, 0.84 +/- 0.32, 11.4 +/- 4.5 vs 1.80 +/- 0.9, 0.89 +/- 0.48, 10.8 +/- 6.2). However, pyruvate to lactate ratios were significantly lower in HCC patients (7.45 +/- 1.57 vs 8.62 +/- 2.15, p less than 0.05). Among the HCC patients the levels of pyruvate and lactate were significantly higher in patients with liver cirrhosis (LC) than those in patients without LC. The sequential changes of KBRs and levels of pyruvate and lactate were examined before and after transcatheter arterial embolization (TAE). Although KBRs were transiently decreased immediately after TAE, they were at higher levels from the 3rd to 21st day in comparison with those before TAE. The levels of pyruvate and lactate showed no significant changes immediately after TAE. However, they followed a course similar to that of KBRs after TAE. Lower KBRs and higher levels of pyruvate and lactate tended to be observed in HCC patients with LC after TAE than in those without LC. This suggests a decrease of intrahepatic blood flow probably due to histological reconstruction. These results suggest that the presence of LC is one of the most important factors influencing the functional reserve of liver in HCC patients. In HCC patients without LC, the recovery from the overload of TAE may operate at mitochondrial levels at least the 3rd day after TAE.
检测了肝细胞癌（HCC）患者动脉血中的酮体比率（乙酰乙酸/3-羟基丁酸：KBR）以及丙酮酸和乳酸水平。HCC患者的KBR以及丙酮酸和乳酸水平与无肝脏疾病患者相似（分别为1.57±0.88、0.84±0.32、11.4±4.5与1.80±0.9、0.89±0.48、10.8±6.2）。然而，HCC患者的丙酮酸与乳酸比率显著更低（7.45±1.57与8.62±2.15，p<0.05）。在HCC患者中，肝硬化（LC）患者的丙酮酸和乳酸水平显著高于无LC的患者。在经动脉导管栓塞术（TAE）前后检测了KBR以及丙酮酸和乳酸水平的连续变化。尽管TAE后KBR立即短暂下降，但与TAE前相比，在第3至21天其处于更高水平。TAE后丙酮酸和乳酸水平立即无显著变化。然而，它们在TAE后的变化过程与KBR相似。TAE后，有LC的HCC患者比无LC的患者往往KBR更低，丙酮酸和乳酸水平更高。这提示可能由于组织重建导致肝内血流减少。这些结果表明，LC的存在是影响HCC患者肝脏功能储备的最重要因素之一。在无LC的HCC患者中，至少在TAE后第3天，从TAE负荷中的恢复可能在线粒体水平起作用。
