Cerebrospinal Fluid Lactate in Patients with Hepatic Encephalopathy
作者:
Hiroshi Yao,
Seizo Sadoshima,
Kenichiro Fujii,
Kenji Kusuda,
Takao Ishitsuka,
Kinya Tamaki,
Masatoshi Fujishima,
期刊:
European Neurology
(Karger Available online 1987)
卷期:
Volume 27,
issue 3
页码: 182-187
ISSN:0014-3022
年代: 1987
DOI:10.1159/000116153
出版商: S. Karger AG
关键词: Lactate;Pyruvate;Hepatic encephalopathy;Acid-base balance;Cerebrospinal fluid
数据来源: Karger
摘要:
Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 16 patients with hepatic encephalopathy before and/or after treatment. CSF lactate was significantly increased to 1.92 ± 0.11 mmol/1 in hepatic encephalopathy before the treatment in comparison to 1.40 ± 0.05 mmol/1 in control subjects. In 9 of 11 patients with moderate or stage 2 encephalopathy, CSF lactate levels were below 2 mmol/1. In contrast, in 4 of 5 patients with stage 3–4 encephalopathy, CSF lactate levels were higher than 2 mmol/1. CSF lactate was decreased with the recovery of neurological symptoms by the treatment. These findings indicate that CSF lactate levels reflect the severity of metabolic impairment of the brain. Hypocapnia was frequently observed in these encephalopathic patients, and arterial Pco2 correlated inversely with CSF lactate and linearly with CSF HCO–3, suggesting that CSF lactic acidosis contributes to hyperventilation in hepatic encephalopathy. It is concluded from present results that metabolic disorder of neuronal cells might be one of the important factors for the development of hepatic encephalo
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