Liu G, Wang M Q, Kagawa T, Wada S, Morita S, Ohno Y, Shinbara K, Nomimura T, Hayashi S, Orihashi K
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Surg Gynecol Obstet. 1993 Nov;177(5):507-12.
To examine the effects of extracorporeal circulation using an artificial heart and lung machine on hepatic energy metabolism in patients with cardiac operation using hypothermia, the arterial blood ketone body ratio (AKBR) reflecting the hepatic mitochondrial redox state was determined in 12 patients who had undergone cardiac operation using extracorporeal circulation from March to August 1991. Changes in AKBR were compared with those before and after extracorporeal circulation. AKBR decreased significantly after the beginning of extracorporeal circulation (p < 0.001) and remained at a lower level throughout extracorporeal circulation. On termination of extracorporeal circulation, the initial level was immediately resumed. The extent of decrease in ketone body ratio at ten minutes before termination of extracorporeal circulation was correlated with short term postoperative hepatic insufficiency. The patients whose ratio decreased below 0.4 showed increased levels in glutamic-pyruvic transaminase at the end of the first and second week after operation. Changes in AKBR were significantly associated with those in blood pressure (r = 0.433; p < 0.005) and body temperature (r = 0.472; p < 0.005). It was concluded that blood pressure and body temperature influence the blood ketone body ratio during extracorporeal circulation.
为研究使用人工心肺机进行体外循环对低温心脏手术患者肝脏能量代谢的影响，对1991年3月至8月间接受体外循环心脏手术的12例患者测定了反映肝脏线粒体氧化还原状态的动脉血酮体比值（AKBR）。将AKBR的变化与体外循环前后的变化进行比较。体外循环开始后AKBR显著下降（p<0.001），并在整个体外循环过程中维持在较低水平。体外循环结束时，立即恢复到初始水平。体外循环结束前10分钟酮体比值的下降程度与术后短期肝功能不全相关。比值降至0.4以下的患者在术后第一周和第二周结束时谷丙转氨酶水平升高。AKBR的变化与血压（r = 0.433；p<0.005）和体温（r = 0.472；p<0.005）的变化显著相关。得出的结论是，血压和体温在体外循环期间影响血酮体比值。
