Baker A, Girling A, Worthington D, Ballantine N, Smith S, Tarlow M, Kelly D
Liver Unit, Children's Hospital, Ladywood Middleway.
J Pediatr Gastroenterol Nutr. 1995 Feb;20(2):196-201. doi: 10.1097/00005176-199502000-00010.
To evaluate its clinical value, the half-life of caffeine (1,3,7-trimethylxanthine) in saliva (SCT) after 3 mg/kg-1 oral caffeine was measured in 53 children with chronic liver disease (mean age, 4.41 years) and 48 control children (mean age, 6.26 years) in five samples over 24 h and compared with parameters of liver function and outcome. Sensitivity was 60.3% and specificity 97% of SCT for diagnosis of chronic liver disease. The correlation of SCT with serum albumin (ALB) was -0.52 (p < 0.001), total bilirubin (SBR) was 0.585 (p < 0.001), prolonged prothrombin time (PT) was 0.387 (p = 0.004), and aspartate aminotransferase (AST) was 0.538 (p = 0.001). The correlation of SCT with a clinical score of liver dysfunction calculated from the presence of features of hepatic decompensation was 0.627 (p < 0.001) and with Malatack's paediatric prognostic score was 0.505 (p < 0.001). Serial SCT and liver function tests were performed on 53 patients on 127 occasions during a mean follow-up of 361 days (range, 4-709). Of this group, 18 were listed for liver transplantation. Predictive values of outcome by analysis of variance expressed as ratio of mean squares were SBR, 34.1 (p < 0.001); log10 SCT, 20.6 (p < 0.001); ALB, 5.2 (p < 0.05); PT, 1.2 (NS). SCT correlated with clinical and biochemical parameters of severity of liver disease, but SBR was a better predictor of listing for liver transplantation in this group of paediatric patients.
为评估其临床价值，对53例慢性肝病患儿（平均年龄4.41岁）和48例对照儿童（平均年龄6.26岁）口服3mg/kg咖啡因后24小时内五个时间点唾液中咖啡因（1,3,7 - 三甲基黄嘌呤）的半衰期（SCT）进行了测量，并与肝功能参数和预后进行比较。SCT诊断慢性肝病的敏感性为60.3%，特异性为97%。SCT与血清白蛋白（ALB）的相关性为 -0.52（p < 0.001），与总胆红素（SBR）为0.585（p < 0.001），与凝血酶原时间延长（PT）为0.387（p = 0.004），与天门冬氨酸氨基转移酶（AST）为0.538（p = 0.001）。SCT与根据肝失代偿特征计算的肝功能不全临床评分的相关性为0.627（p < 0.001），与马拉塔克儿科预后评分的相关性为0.505（p < 0.001）。在平均361天（范围4 - 709天）的随访期间，对53例患者进行了127次连续SCT和肝功能检查。该组中有18例被列入肝移植名单。通过方差分析表示为均方比的预后预测值为：SBR，34.1（p < 0.001）；log10 SCT，20.6（p < 0.001）；ALB，5.2（p < 0.05）；PT，1.2（无统计学意义）。SCT与肝病严重程度的临床和生化参数相关，但在这组儿科患者中，SBR是肝移植名单的更好预测指标。
