Elin R J, Fried M W, Sampson M, Ruddel M, Kleiner D E, DiBisceglie A M
Clinical Pathology Department, Warren Grant Magnuson Clinical Center, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892-1508, USA.
Clin Chem. 1997 Oct;43(10):1952-7.
The liver metabolizes lidocaine by oxidative deethylation to form monoethylglycinexylidide (MEGX), an analyte proposed as an index of liver function. We determined MEGX and lidocaine serum concentrations with the TDx (Abbott Laboratories) at baseline and 15, 30, 60, and 90 min after the intravenous administration of lidocaine (1 mg/kg), analyzing specimens from 12 apparently healthy volunteers and 40 patients with chronic viral hepatitis diagnosed by liver biopsy and serum tests. The patients were grouped on the basis of the histology activity index. The following laboratory tests were performed on serum specimens from all subjects: albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, total bilirubin, and prothrombin time. The results showed no significant difference among the four groups for the concentrations of MEGX, lidocaine, and lidocaine/MEGX at the four time points. However, the concentrations of ALB, ALT, AST, AST/ALT, and prothrombin time were substantially different among the four groups. Thus, we conclude that assay of MEGX in our patients with chronic viral hepatitis did not contribute to the assessment of liver function when compared with apparently healthy volunteers and traditional tests of liver function.
肝脏通过氧化脱乙基作用代谢利多卡因,形成单乙基甘氨酰二甲苯胺(MEGX),一种被提议作为肝功能指标的分析物。我们在静脉注射利多卡因(1mg/kg)后的基线、15、30、60和90分钟,使用TDx(雅培实验室)测定了MEGX和利多卡因的血清浓度,分析了12名明显健康志愿者以及40名经肝活检和血清检测确诊为慢性病毒性肝炎患者的样本。根据组织学活动指数对患者进行分组。对所有受试者的血清样本进行了以下实验室检测:白蛋白(ALB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶、总胆红素和凝血酶原时间。结果显示,四组在四个时间点的MEGX、利多卡因和利多卡因/MEGX浓度之间无显著差异。然而,四组之间的ALB、ALT、AST、AST/ALT和凝血酶原时间浓度存在显著差异。因此,我们得出结论,与明显健康的志愿者和传统肝功能检测相比,在我们的慢性病毒性肝炎患者中检测MEGX对肝功能评估并无帮助。