科研之友
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摘要
Background: The effect of liver resection on acetaminophen metabolism and whether it is affected by residual liver volume is poorly understood. Methods: We investigated the effects of liver resection on acetaminophen metabolism in a single centre, prospective observational, case-control study of inpatients. Patients undergoing liver resection were administered therapeutic post-operative acetaminophen. Glutathione and urinary acetaminophen metabolites were measured over the first three post-operative days and compared between patients with low (Group A) and high (Group B) residual liver volume. Results: 41 patients (41% female, median age 62 [IQR 53-72] years) were included. Mean urinary cysteine levels increased significantly from post-operative day 1 to 2 (578.0 mg/day 95% CI 478.9-677.1 vs. 775.4 mg/day, 95% CI 625.7-925.1; p = 0.03). Group A (n = 11) had significantly higher median levels of cysteine (day 1, 464.3 mg/day [IQR 355.6-582.0]; day 3, 717.6 mg/day [IQR 423.5-1104.0]) compared to Group B (n = 11): day 1, 545.4 mg/day (IQR 346.9-843.5); day 3, 508.1 mg/day (IQR 390.8-788.4; p = 0.048). No significant difference was observed in glutathione or 5-oxoproline levels between the groups. Conclusion: Low residual liver volume results in altered acetaminophen metabolism, however, no evidence of glutathione deficiency was observed. Therapeutic acetaminophen is safe after major liver resection provided liver function is adequate.
- 出版日期2015-12
