Yamamoto M, Fujii H, Sugahara K, Kawashima S, Ozawa K, Tobe T
Jpn J Surg. 1985 Jan;15(1):18-22. doi: 10.1007/BF02469852.
Factors related to the prognosis of patients with hyperbilirubinemia were investigated in 16 highly jaundiced patients. Patients who died within 3 weeks showed a deterioration of the hepatic energy status, measured by the arterial ketone body ratio, but patients who did not die within 3 weeks after the measurement of the ketone body ratio had a ratio within the normal range, despite high total bilirubin levels (18 mg/0.1 L). C3, C4 and CH50 in the former were also significantly lower than those in the latter. However, endotoxin and high fever occurred to the same extent, in the both groups. Thus, hepatic energy balance is the most pertinent factor related to prognosis, and is concerned with both the hepatocyte and reticuloendothelial systems. On the other hand, infection or endotoxin, when the energy balance is disturbed, becomes an aggravating but not a fundamental factor.
对16例高度黄疸患者进行了高胆红素血症患者预后相关因素的研究。在3周内死亡的患者，通过动脉酮体比率测量显示肝脏能量状态恶化，但在测量酮体比率后3周内未死亡的患者，尽管总胆红素水平较高（18mg/0.1L），其比率仍在正常范围内。前者的C3、C4和CH50也显著低于后者。然而，两组内毒素和高热的发生程度相同。因此，肝脏能量平衡是与预后最相关的因素，并且与肝细胞和网状内皮系统均有关。另一方面，当能量平衡受到干扰时，感染或内毒素会成为一个加重因素，但不是根本因素。
