Scaiola A, MacMathuna P, Langley P G, Gove C D, Hughes R D, Williams R
Liver Unit, King's College Hospital, Denmark Hill, London, U.K.
Hepatogastroenterology. 1990 Aug;37(4):413-6.
The ratio of acetoacetate to beta-hydroxybutyrate, the ketone body ratio, was measured in arterial blood from 28 patients with fulminant hepatic failure as an index of the hepatic energy charge. The ketone body ratio was significantly reduced in the total group of patients with fulminant hepatic failure as compared with control subjects (0.27 +/- 0.03 SE as compared with 0.48 +/- 0.03; p less than 0.001). Patients who survived had significantly less reduction of the ketone body ratio on admission than those who died (0.39 +/- 0.06, n = 10 as compared with 0.20 +/- 0.02, n = 19; p less than 0.02). In seven patients who died, in whom ketone body ratio was measured less than 12 hours before death there was a significant decrease in ketone body ratio as compared with that on admission (0.24 +/- 0.05 to 0.15 +/- 0.04; p less than 0.05). In contrast, in seven patients who survived there was no significant change in ketone body ratio when measured within 12 hours of regaining consciousness as compared with the figures on admission. Measurement of arterial ketone body ratio may give an indication of prognosis, and may be of use in testing the efficacy of treatments which aim to enhance hepatic regeneration or to remove toxic substances that may reduce the hepatic energy charge.
对28例暴发性肝衰竭患者的动脉血进行检测，以乙酰乙酸与β-羟丁酸的比值即酮体比值作为肝脏能量代谢状态的指标。与对照组相比，暴发性肝衰竭患者总体的酮体比值显著降低（分别为0.27±0.03标准误与0.48±0.03；P<0.001）。存活患者入院时酮体比值的降低幅度显著小于死亡患者（分别为0.39±0.06，n=10与0.20±0.02，n=19；P<0.02）。在7例死亡患者中，在死亡前12小时内检测了酮体比值，与入院时相比，酮体比值显著下降（从0.24±0.05降至0.15±0.04；P<0.05）。相比之下，7例存活患者在意识恢复后12小时内检测的酮体比值与入院时相比无显著变化。测定动脉血酮体比值可能有助于判断预后，也可用于检验旨在促进肝脏再生或清除可能降低肝脏能量代谢状态的有毒物质的治疗方法的疗效。
