Spies C D, Herpell J, Beck O, Müller C, Pragst F, Borg S, Helander A
Department of Anesthesiology and Operative Intensive Care Medicine, Benjamin Franklin Medical Center, Free University Berlin, Germany.
Alcohol. 1999 Jan;17(1):19-27. doi: 10.1016/s0741-8329(98)00028-7.
The urinary ratio of 5-hydroxytryptophol to 5-hydroxyindole-3-acetic acid was reported to be elevated for a period of up to 22 h following acute alcohol ingestion. Therefore, the ratio could detect continuous alcohol consumption, in what was considered to be a high-risk surgical group, on the evening prior to surgery. The aim of this study was to determine the preoperative ratio of 5-hydroxytryptophol to 5-hydroxyindole-3-acetic acid in patients with continuous preoperative alcohol misuse. Forty-two patients participated in this institutionally approved study, once their written informed consent had been obtained. Chronic alcoholics were defined by meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders criteria and an ethanol consumption > or =60 g/day. The urine samples were taken preoperatively and determined by means of gas chromatography-mass spectrometry and high performance liquid chromatography. The urinary ratio of 5-hydroxytryptophol to 5-hydroxyindole-3-acetic acid was significantly increased in chronic alcoholics. The ICU stay of these patients was significantly prolonged due to an increased incidence of pneumonia and sepsis. Five chronic alcoholics died, whereas no deaths occurred in the nonalcoholic group (p = 0.05). As the measurement of the urinary ratio of 5-hydroxy-tryptophol to 5-hydroxyindole-3-acetic acid could detect alcohol consumption immediately prior to operation, this marker could assist the carbohydrate-deficient transferrin in screening for patients with high-level dependency; these patients were considered to be at a high risk of developing intercurrent complications.
据报道，急性酒精摄入后长达22小时内，尿中5-羟色醇与5-羟吲哚-3-乙酸的比值会升高。因此，在一个被认为是高风险手术组的患者中，该比值可在手术前一晚检测出持续饮酒情况。本研究的目的是确定术前持续滥用酒精患者的5-羟色醇与5-羟吲哚-3-乙酸的术前比值。42名患者在获得机构批准并签署书面知情同意书后参与了本研究。慢性酒精中毒者的定义为符合《精神疾病诊断与统计手册》标准且乙醇摄入量≥60克/天。术前采集尿样，采用气相色谱-质谱联用和高效液相色谱法进行测定。慢性酒精中毒患者尿中5-羟色醇与5-羟吲哚-3-乙酸的比值显著升高。由于肺炎和败血症的发生率增加，这些患者在重症监护病房的停留时间显著延长。5名慢性酒精中毒患者死亡，而非酒精组无死亡病例（p = 0.05）。由于测定尿中5-羟色醇与5-羟吲哚-3-乙酸的比值可在手术前即刻检测出酒精摄入情况，该标志物可辅助缺糖转铁蛋白筛查高度依赖酒精的患者；这些患者被认为发生并发并发症的风险很高。
