Ozawa K
Nihon Geka Gakkai Zasshi. 1983 Sep;84(9):753-7.
In a recent study from our laboratory, 372 patients were classified into 4 groups according to the postoperative changes in the arterial blood ketone body ratio: Group A without decrease below 0.7 (greater than 0.7 in control), Group B with transient decrease to 0.4, Group C with progressive decrease to below 0.4, and Group D, the terminal stage, with decrease to below 0.25. Groups A and B patients tolerated operation well. In the 28 Group C patients, 24 of them died of multiple organ failure. The metabolic liver support designed by us (an ex vivo pig or baboon liver cross-hemodialysis with an interposed cuprophan membrane) has been applied for the patients with both blood ketone body ratio below 0.4 and grade IV hepatic coma. All Group C patients became fully alert after liver support concomitant with the restoration of the blood ketone body ratio. By contrast, in Group D patients, there was no restoration of consciousness and no improvement in their blood ketone body ratios by this liver support. It has been suggested that blood ketone body ratio level serves as an excellent indicator of the deranged metabolic process and mortality in critically ill patients.
在我们实验室最近的一项研究中，372名患者根据术后动脉血酮体比值的变化被分为4组：A组术后未降至0.7以下（对照组大于0.7），B组暂时降至0.4，C组逐渐降至0.4以下，D组为终末期，降至0.25以下。A组和B组患者手术耐受性良好。在28例C组患者中，24例死于多器官功能衰竭。我们设计的代谢性肝脏支持（通过插入铜仿膜进行体外猪或狒狒肝脏交叉血液透析）已应用于血酮体比值低于0.4且处于IV级肝昏迷的患者。所有C组患者在肝脏支持后随着血酮体比值的恢复而完全清醒。相比之下，在D组患者中，这种肝脏支持未能使意识恢复，血酮体比值也没有改善。有人提出，血酮体比值水平是危重病患者代谢紊乱过程和死亡率的一个极佳指标。
