Pearl R H, Clowes G H, Bosari S, McDermott W V, Menzoian J O, Love W, Jenkins R L
Arch Surg. 1987 Apr;122(4):468-73. doi: 10.1001/archsurg.1987.01400160094015.
The central plasma clearance rate of amino acids (CPCR-AA), the ratio of peripheral amino acid entry rate into blood plasma to arterial amino acid concentration, was measured preoperatively in 149 noninfected cirrhotic patients. In 50 survivors of shunting or general surgical procedures, the mean (+/- SEM) CPCR-AA was 201 +/- 17 mL/m2/min; in 39 subsequent deaths, the mean ratio was 87 +/- 14 mL/m2/min. Comparing Child's classification with CPCR-AA reveals the following values: class A (mortality, two of ten patients) survivors, 152 +/- 23 mL/m2/min; class A deaths, 96 +/- 54 mL/m2/min; class C (mortality, 13 of 19 patients) survivors, 214 +/- 47 mL/m2/min; class C deaths, 101 +/- 13 mL/m2/min. The preoperative CPCR-AA of 46 patients receiving liver transplants was 91 +/- 9 mL/m2/min; 69% of these patients survived. Preoperative CPCR-AA values correlated significantly with rates of hepatic protein synthesis in incubated liver slices obtained by biopsy at operation in 22 patients. Thus, CPCR-AA determination is a true liver function test, valuable in predicting surgical mortality and selecting transplantation or other operations for cirrhotic patients.
在149例未感染的肝硬化患者术前测量了氨基酸的中央血浆清除率（CPCR-AA），即外周氨基酸进入血浆的速率与动脉氨基酸浓度之比。在50例分流手术或普通外科手术的幸存者中，CPCR-AA的平均值（±标准误）为201±17 mL/m²/min；在随后死亡的39例患者中，该平均比值为87±14 mL/m²/min。将Child分级与CPCR-AA进行比较得出以下数值：A类（10例患者中有2例死亡）幸存者，152±23 mL/m²/min；A类死亡患者，96±54 mL/m²/min；C类（19例患者中有13例死亡）幸存者，214±47 mL/m²/min；C类死亡患者，101±13 mL/m²/min。46例接受肝移植患者的术前CPCR-AA为91±9 mL/m²/min；这些患者中有69%存活。术前CPCR-AA值与22例患者术中活检获得的孵育肝切片中的肝蛋白合成速率显著相关。因此，CPCR-AA测定是一项真正的肝功能检查，对于预测手术死亡率以及为肝硬化患者选择移植或其他手术具有重要价值。
