Ballarè M, Avagnina P, Torchio M, Cavanna A, Aurucci P E, Niro A G, Molino G
Dipartimento di Biomedicina, Università degli Studi di Torino.
Ric Clin Lab. 1988 Oct-Dec;18(4):305-11. doi: 10.1007/BF02919088.
The hepatic clearance of D-sorbitol was proven to be a reliable parameter for evaluating the functional liver plasma flow. Twenty-five normal subjects and 50 cirrhotic patients were studied in order to assess if the measure of the plasma disappearance rate of sorbitol can be used as a simpler procedure to evaluate changes in liver perfusion and to predict modifications of drug bioavailability due to circulatory events. The plasma disappearance rate was calculated between 10 and 20 min after intravenous administration of a 2-g dose because in this time interval plasma levels were in the optimum range for the chemical assay, and the plasma concentration/time curve fitted a decreasing exponential function. Plasma disappearance rate values were found to correlate significantly (r = 0.666, p less than 0.001) with sorbitol hepatic clearance, as calculated after the 2-h test. The test had a good day-to-day reproducibility both in normal subjects and cirrhotic patients. In 5 patients submitted to surgical side-to-side portacaval shunt, decreases of plasma disappearance rate and sorbitol hepatic clearance showed no significant difference. Mean values (+/- SD) of D-sorbitol plasma disappearance rate were 0.048 +/- 0.014 min-1 in cirrhotic patients, and 0.081 +/- 0.014 min-1 in normal subjects (p less than 0.001).
已证实D - 山梨醇的肝清除率是评估功能性肝血浆流量的可靠参数。为了评估山梨醇血浆消失率的测量是否可以作为一种更简单的方法来评估肝脏灌注的变化，并预测由于循环事件导致的药物生物利用度的改变，对25名正常受试者和50名肝硬化患者进行了研究。血浆消失率是在静脉注射2克剂量后10至20分钟之间计算的，因为在此时间间隔内血浆水平处于化学分析的最佳范围内，并且血浆浓度/时间曲线符合递减指数函数。发现血浆消失率值与2小时测试后计算的山梨醇肝清除率显著相关（r = 0.666，p < 0.001）。该测试在正常受试者和肝硬化患者中均具有良好的每日重复性。在5名接受手术侧侧门腔分流术的患者中，血浆消失率和山梨醇肝清除率的降低无显著差异。肝硬化患者D - 山梨醇血浆消失率的平均值（±SD）为0.048±0.014 min⁻¹，正常受试者为0.081±0.014 min⁻¹（p < 0.001）。
