Abei M, Tanaka E, Tanaka N, Matsuzaki Y, Ikegami T, Ishikawa A, Osuga T
Department of Gastroenterology, University of Tsukuba, Ibaraki, Japan.
J Gastroenterol. 1995 Aug;30(4):478-84. doi: 10.1007/BF02347564.
Trimethadione (TMO) was chosen as an indicator of quantitative hepatic microsomal function, and its pharmacokinetics were studied in 52 patients with chronic hepatitis. Findings in these patients were compared with those for 26 healthy subjects and 13 patients with renal failure. Patients with chronic hepatitis, but not those with renal failure, showed significant reduction in clearance (CL) and prolongation of half-life (t1/2), and the extent of abnormalities was found to reflect the severity of histologic changes in liver tissue. The serum dimethadione (DMO)/TMO ratio 4 h after the administration of TMO altered in parallel with the CL and t1/2 of TMO, and abnormalities in this simple ratio were also related to the histologic severity of changes in the liver tissue. A low DMO/TMO ratio (< 0.4) was associated with advanced histologic changes (chronic active hepatitis with bridging or chronic active hepatitis with cirrhosis), whereas a high DMO/TMO ratio (> 0.4) was associated with mild histologic changes (chronic persistent hepatitis or chronic active hepatitis) (sensitivity, 0.81; specificity, 0.86). These results indicate that the DMO/TMO ratio, which can be obtained from a single blood sampling, reflects the histologic severity of changes in tissue liver, and that the TMO tolerance test is a useful indicator of quantitative liver function.
选用三甲双酮（TMO）作为肝脏微粒体定量功能的指标，并对52例慢性肝炎患者的药代动力学进行了研究。将这些患者的研究结果与26名健康受试者和13例肾衰竭患者的结果进行了比较。慢性肝炎患者而非肾衰竭患者，其清除率（CL）显著降低，半衰期（t1/2）延长，且异常程度反映了肝组织组织学改变的严重程度。给予TMO 4小时后的血清二甲双酮（DMO）/TMO比值与TMO的CL和t1/2平行变化，这一简单比值的异常也与肝组织改变的组织学严重程度相关。低DMO/TMO比值（<0.4）与严重组织学改变（桥接性慢性活动性肝炎或肝硬化慢性活动性肝炎）相关，而高DMO/TMO比值（>0.4）与轻度组织学改变（慢性持续性肝炎或慢性活动性肝炎）相关（敏感性为0.81；特异性为0.86）。这些结果表明，可通过单次采血获得的DMO/TMO比值反映了肝组织改变的组织学严重程度，且TMO耐量试验是定量肝功能的有用指标。
