Omori N, Ukida M, Mikami M, Morimoto Y, Tsuji T
First Department of Internal Medicine, Okayama University Medical School, Japan.
Acta Med Okayama. 1994 Jun;48(3):159-64. doi: 10.18926/AMO/31122.
Of the eight patients with fulminant hepatitis placed under total parenteral nutrition with an amino acid solution rich in branched chain amino acids and treated by plasma exchange, four survived and four died from hepatic failure. Serum uric acid levels in the non-survived group were significantly lower on days 1-6 compared with the survived group. The concentration ratios of uric acid to creatinine and prothrombin time were significantly lower on days 5-8 and days 3-8, respectively, in a similar comparison. Thus, the uric acid to creatinine ratio, which corrects for the possible renal dysfunction associated with acute hepatic failure, may serve as a clinically useful prognostic indicator for patients with fulminant hepatitis.
在8例暴发性肝炎患者中，采用富含支链氨基酸的氨基酸溶液进行全胃肠外营养，并接受血浆置换治疗，4例存活，4例死于肝衰竭。与存活组相比，未存活组在第1 - 6天的血清尿酸水平显著降低。在类似的比较中，尿酸与肌酐的浓度比在第5 - 8天显著降低，凝血酶原时间在第3 - 8天显著降低。因此，校正了与急性肝衰竭相关的可能肾功能障碍的尿酸与肌酐比值，可能作为暴发性肝炎患者临床上有用的预后指标。
