Cavanna A, Molino G, Ballarè M, Torchio M, Fracchia M, Avagnina P, Bircher J
Dipartimento di Biomedicina, Università di Torino, Italy.
J Hepatol. 1987 Oct;5(2):154-61. doi: 10.1016/s0168-8278(87)80567-6.
Portal-systemic shunting is an important circulatory abnormality in patients with cirrhosis. This study explores the potential of the natural polyol D-sorbitol as test compound for non-invasive assessment of shunting. Ten normal subjects, 10 patients with cirrhosis and 12 cirrhotics with surgical portacaval shunts were studied after oral and intravenous administration of a 2 g dose of sorbitol. As measured by the H2 breath test, removal from the intestinal lumen was complete in both groups. Bioavailability of sorbitol, calculated as ratio of the areas under the plasma concentration/time curve after p.o. and i.v. administration, was zero in normal subjects, 0.29 +/- 0.15 in cirrhotic patients, and 0.38 +/- 0.11 in patients with portacaval shunts. Calculation of bioavailability on the basis of urinary outputs of sorbitol gave similar results. It is concluded that the bioavailability of sorbitol reflects portal-systemic shunting, although the relatively low figures suggest some degree of sorbitol metabolism by enterocytes.
门体分流是肝硬化患者重要的循环异常。本研究探讨天然多元醇D - 山梨醇作为检测化合物用于分流无创评估的潜力。对10名正常受试者、10名肝硬化患者和12名接受外科门腔分流术的肝硬化患者口服和静脉注射2g剂量的山梨醇后进行了研究。通过氢气呼气试验测定，两组中肠腔内山梨醇的清除均完全。山梨醇的生物利用度，以口服和静脉给药后血浆浓度/时间曲线下面积之比计算，正常受试者为零，肝硬化患者为0.29±0.15，门腔分流患者为0.38±0.11。根据山梨醇的尿量计算生物利用度得出了相似的结果。结论是，山梨醇的生物利用度反映了门体分流，尽管相对较低的数值表明肠细胞对山梨醇有一定程度的代谢。
