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- 주제어 : arterial keton body ratio (검색결과 4 건)
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간 절제술후 초기 예후 인자로서의 동맥혈 Ketone Body Ratio의 의의
전용성(Yong Sung Jeon),김홍진(Hong Jin Kim),심민철(Min Chul Shim),권굉보(Koing Bo Kwun) 대한소화기학회 1995 대한소화기학회지 Vol.27 No.5
N/A Background/Aims: Recent surgical techniques have enabled surgeons to undertake radical operations for a much wider range of liver diseases, but the invasive nature of such operations requires that they be followed up by careful and intensive postoperative management. Since the introduction of the oxidation-reduction(redox) theory in the beginning of 1980s, the significance of the arterial ketone body ratio(acetoactate/g-hydroxybutylate), which reflects hepatic mitochondria] oxidation-reduction potential, has been discussed as one of the metabolic parameters of organ failure. The aim of this study was to assess the significance of arterial ketone body ratio as an early prognostic indicator in liver surgery. Methods: In this study, arterial ketone body ratio and total ketone body concentration were serially measured in 83 patients who underwent liver resection in the department of surgery of Youngnam University Hospital between May 1992 and Feburary 1994. Results: At the postoperative 1 day, arterial ketone body ratio was significantly higher in successful recovery group(n=71, 1.22 0.59) than that of the postoperative complication and mortality group(n=12, 0.66 l 0.34). And patients were classified into three groups by the decrease of ketone body ratio in the postoperative 1 day: group A(70 cases) with ketone body ratio above 0.7, group B(12 cases) between 0.7 and 0.4, and group C(1 case) below 0.4. In group A, 63 patients(90%) were recovered, 6 patients complicated and 1 patient dead. In B group, 8 patients(66.6%) was recovered, 2 patients complicated and 2 patients dead. The only patient of group C(100%) was dead. Conclusions: Postoperative AKBR is useful as an early prognostic indicator in liver surgery, and maintenance of AKBR above 0.7 is crucial to obtain a good surgical outcome. (Korean J Gastroenterol 1995;27: 555 - 562)
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이원흥,왕희정,소의영,손우영,김욱환,김명욱 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1
Changes in arterial ketone body ratio(AKBR) during and after liver surgery were investigated in 11 patients who underwent partial hepatectomy or orthotopic liver transplantation during the period from April 1995 through June 1995. During partial hepatectomy, hepatic vascular occlusion induced reduction in AKBR to below 0.4 in 10 cases, indicating that AKBR rapidly reflects the intraoperative metabolic insults imposed on the liver. After the completion of operation, AKBR's returned to the normal value of above 0.7 in cases without cirrhosis. In contrast, 4 of 5 cases with cirrhosis exhibited delayed recovery of AKBR(p=0.053). The mean value of ICG R15 in the delayed recovery group of serial AKBR was 14.7%, significantly lower than 8.0% in the rapid recovery group(p=0.031). It seems that postoperative restoration of liver function in patients with poor hepatic functional reserve takes more time, as reflected in delayed recovery of AKBR. Changes in AKBR during and after liver transplantation were as follows: reduction to below 0.4 during anhepatic phase; recovery to above 0.4 concomitant with functioning of the new liver; maintenance at over 0.7 during the first week after the operation. Such findings were useful in monitoring the function of the grafted liver during the critical perioperative period.
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뇌사환자의 갑상선 기능, 전신대사 및 중증도에 관한 연구
이영주,정금희,왕희정,문봉기,한연희,이영석 아주대학교 의과학연구소 1999 아주의학 Vol.4 No.1
Background and Objectives : Brain death may lead to hormonal depletion, metabolic derangement and multiple organ dysfunction. We have carried out present study to examine the effects of brain death on the thyroid function, metabolic indices, and the severity scoring systems. Methods : 13 adults patients admitted for organ donation or brain death evaluation were examined after brain death was confirmed. Thyroid hormones measured were .thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and free thyroxine (FT4). The metabolic indices measured were arterial ketone body ratio (AKBR), lactic acid (LA), and base defiat (BD). as for reference to the severity scoring systems, APACHE Ⅲ and multiple organ failure score (MOFS) were assessed on the day of brain death confirmation. Arterial blood was drawn for all measurements. Results : As for the thyroid function, there were significant decreases in T3 (40.48±20.96 ng/dL) and T4 (3.47±2.15 ㎍/dL), but no significant change in FT4 (0.75±0.31 ng/dL) and TSH (1.12±1.37 uIU/mL) compared to the normal range. Significant decreases in AKBR (0.39±0.31) and BD (-9.46±5.83 m㏖/L), and significant increase in LA (2.57±2.46 m㏖/L) In metabolic indices, were shown, as for severity scoring systems, APACHE Ⅲ score (101.54±19.41) and MOF score (9.11±2.57) indicated a high mortality. There were significant correlation between thyroid hormones (r=0.565 -0.781) but no correlation among other indices. Also, significant inverse correlations were shown between base deficit and lactic acid (r=-0.660), APACHE Ⅲ score (r=-0.726) and MOF score (r=-0.604). The highest correlation was observed between APACHE Ⅲ score and MOF score (r=0.851). Conclusions : As for the thyroid function, significant decrease in T3 and T4, and almost normal range of FT4 and TSH imply the euthyroid sick syndrome. Abnormal finding of the metabolic parameters indicates an inhibition of the aerobic metabolic rate of the body as a whole. And the severity scoring parameters are compatible with high mortality.
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