Terada Y, Eguchi Y, Chang Y J, Tabata R, Sakumoto H, Takehiro O, Uno S, Ozawa K
Intensive Care Unit, Shiga University of Medical Science, Otsu, Japan.
Clin Chim Acta. 1996 Mar 29;247(1-2):81-8. doi: 10.1016/0009-8981(95)06237-8.
To investigate the ketone body ratio (acetoacetate/3-hydroxybutyrate) of central venous blood compared to that of peripheral arterial blood, the acetoacetate and 3-hydroxybutyrate concentrations in paired peripheral arterial and central venous or pulmonary arterial blood were measured. The ketone body concentrations in superior and inferior vena cava blood were significantly (P < 0.0001) lower than those in peripheral arterial blood, whereas those in pulmonary arterial blood were almost the same as those in peripheral arterial blood. These results indicate that ketone bodies were metabolized in the muscles, which reduced their levels in vena cava blood, but ketone bodies newly produced by the liver were transported to the right side of the heart via the hepatic vein, giving concentrations in pulmonary arterial blood that were almost the same as those in peripheral arterial blood. On the other hand, the correlation coefficients (r2) of the arterial blood ketone body ratio to the ratio of superior and inferior vena cava and pulmonary arterial blood were 0.897, 0.767 and 0.882, respectively. The ratios of central venous ketone body ratio/arterial blood ketone body ratio were 0.89 +/- 0.15 in the superior vena cava, 0.64 +/- 0.18 in the inferior vena cava and 1.01 +/- 0.15 in the pulmonary artery.
为了研究中心静脉血与外周动脉血的酮体比率（乙酰乙酸/3-羟基丁酸），我们测量了配对的外周动脉血与中心静脉血或肺动脉血中的乙酰乙酸和3-羟基丁酸浓度。上腔静脉和下腔静脉血中的酮体浓度显著低于外周动脉血（P < 0.0001），而肺动脉血中的酮体浓度与外周动脉血几乎相同。这些结果表明，酮体在肌肉中代谢，这降低了它们在下腔静脉血中的水平，但肝脏新产生的酮体通过肝静脉运输到心脏右侧，使得肺动脉血中的浓度与外周动脉血几乎相同。另一方面，动脉血酮体比率与上腔静脉、下腔静脉和肺动脉血比率的相关系数（r2）分别为0.897、0.767和0.882。上腔静脉中中心静脉酮体比率/动脉血酮体比率为0.89 +/- 0.15，下腔静脉中为0.64 +/- 0.18，肺动脉中为1.01 +/- 0.15。
