Koga K, Ogata M, Shigematsu A
Department of Anesthesiology, University of Occupational and Environmental Health, Kitakyushu.
Masui. 1990 Mar;39(3):308-14.
The changes in arterial ketone body ratio (acetoacetate/beta-hydroxybutyrate) were investigated in 7 patients undergoing hepatectomy under epidural anesthesia with nitrous oxide and oxygen. The plasma levels of glucose, insulin, glucagon, lactate, pyruvate and non-esterified free fatty acid (NEFA) were measured during the operation. The plasma level of insulin activity increased significantly during surgery. The secretory capability of insulin against glucose load was relatively preserved. Arterial ketone body ratio also increased during the operation. The plasma insulin activity was positively correlated significantly with the arterial ketone body ratio (Y = 0.98 + 0.76X; r = 0.76). Both lactate and pyruvate increased significantly during surgery. No remarkable changes of L/P ratio reflecting the redox state in cytoplasma were found in both groups. Our results suggest that the quantity of glucose load and insulin activity should be considered when arterial ketone body ratio is measured during the operation.
对7例在硬膜外麻醉下接受氧化亚氮和氧气辅助肝切除术的患者的动脉酮体比率（乙酰乙酸/β-羟基丁酸）变化进行了研究。在手术过程中测量了血浆中的葡萄糖、胰岛素、胰高血糖素、乳酸、丙酮酸和非酯化游离脂肪酸（NEFA）水平。手术期间血浆胰岛素活性显著增加。胰岛素对葡萄糖负荷的分泌能力相对得以保留。手术期间动脉酮体比率也升高。血浆胰岛素活性与动脉酮体比率呈显著正相关（Y = 0.98 + 0.76X；r = 0.76）。手术期间乳酸和丙酮酸均显著增加。两组均未发现反映细胞质氧化还原状态的L/P比率有明显变化。我们的结果表明，在手术期间测量动脉酮体比率时应考虑葡萄糖负荷量和胰岛素活性。
