Linscheer W G, Castell D O, Platt R R
Gastroenterology. 1969 Oct;57(4):415-23.
Hepatic clearance of a small dose of a medium chain fatty acid was used to estimate portasystemic shunting in patients with cirrhosis. Sodium octanoate dissolved in isotonic saline was administered by rectum (11.4 mg per kg of lean body mass) in three groups of 10 patients with cirrhosis and in 10 noncirrhotic controls. Two groups of patients were classified as mild and severe cirrhotics on the basis of a clinical evaluation. The third group of cirrhotic patients had a surgical portacaval shunt. Serum octanoate levels were measured in each subject for a 1-hr period following the administration of sodium octanoate by rectum. A highly significant difference (P less than 0.001) was demonstrated between all four groups of subjects with highest levels occurring in the shunted cirrhotics and the lowest levels in the control group. Serum levels obtained in 2 patients before and after a portacaval shunt increased by a factor of 2 following the operation. Two patients with proven occlusion of a surgical shunt fell well within the range of the nonoperated cirrhotic patients. The results suggest that the rectal octanoate tolerance test can probably be used for evaluation of collateral circulation in cirrhotic patients and for testing the patency of surgical shunts.
采用小剂量中链脂肪酸的肝清除率来评估肝硬化患者的门体分流情况。将溶解于等渗盐水中的辛酸钠经直肠给药（每千克瘦体重11.4毫克），分为三组，每组10例肝硬化患者以及10例非肝硬化对照者。根据临床评估，两组患者被分类为轻度和重度肝硬化患者。第三组肝硬化患者进行了外科门腔分流术。在经直肠给予辛酸钠后的1小时内，测量每个受试者的血清辛酸盐水平。所有四组受试者之间显示出高度显著差异（P小于0.001），分流的肝硬化患者中水平最高，对照组中水平最低。2例患者在门腔分流术前和术后的血清水平在手术后增加了2倍。2例经证实外科分流闭塞的患者的血清水平完全处于未手术的肝硬化患者范围内。结果表明，直肠辛酸盐耐量试验可能可用于评估肝硬化患者的侧支循环以及检测外科分流的通畅情况。
