联合利用D-山梨醇清除率和超声多普勒评估肝储备功能初探

 目的探讨D-山梨醇肝脏清除率法和超声多普勒法相结合评估肝储备功能的可行性.方法分别给30名研究对象(肝硬化患者及非肝硬化者)静脉稳态滴注D-山梨醇注射液,用酶分光光度法测量其血浆浓度和尿液浓度,据药代动力学公式得出D-山梨醇肝脏清除率;结合超声多普勒所测肝静脉总血流量,计算肝内分流量(率)等指标的变化.结果肝硬化组肝内分流量(率)明显升高,与对照组比较有显著性差异(P＜0.01).结论D-山梨醇肝脏清除率法可反映肝功能性血流量,结合超声多普勒测定肝总血流量可推测肝内分流量(率),它是评估肝储备功能有效的方法.

Evaluation of liver functional reserve by clearance rate of D-sorbitol and Doppler sonography

Objective To evaluate the hepatic function rese rve by using clearance rate of D-sorbitol in combination with Doppler sonograph y.Methods D-sorbitol was infused intravenously at a steady rate in 30 patients with or without liver cirrhosis. Blood and urine concentrati ons of D-sorbitol were examined by enzyme spectrophotometry.From pharmacokineti c equations,hepatic clearance rate of D-sorbitol was calculated. Compared with total hepatic vein blood flow measured by Doppler sonography,intrahepatic shun t(rate) was obtained.Results Intrahepatic shunt was high in cir rhotic group. There was statistical difference in intrahepatic shunt between con trol group and cirrhotic group (P< 0.01).Conclusions Th e hep atic clearance of D-sorbitol can reflect hepatic functional blood flow. Combine d with total hepatic blood flow measured by Doppler sonography,it can estimate intrahepatic shunt (rate),and be used effectively to evaluate liver funct ional reserve.