肝硬変及び肝細胞癌合併肝硬変における肝ミトコンドリア酵素の臨床的,実験的研究--OCTとm-GOTを中心に
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The significance of simultaneous assay of serum ornithine carbamyl transferase (s-OCT) and mitochondrial aspartate aminotransferase (m-GOT) was studied in patients with liver cirrhosis with or without hepatocellular carcinoma (HCC). Parallel elevation of s-OCT and m-GOT was observed in patients with acute and chronic hepatitis and OCT/m-GOT ratio was 1.22 in the former and 1.26 in the latter. However, predominant elevation of s-OCT was observed in patients with liver cirrhosis with or without HCC. This finding was more distinct in liver cirrhosis with hyperammonemia and in cirrhosis with HCC, and OCT/m-GOT ratio was up to 1.74 and 2.1 respectively. Assay of liver tissue concentration of these two enzymes revealed dominant activity of OCT in cirrhotic liver, however, those activities of HCC tissue were low and showed little OCT dominancy.<BR>Significant elevation (p<0.05) of s-OCT acitvity paralleling with increase of OCT activity in liver tissue was noted by loading of 80% casein (high protein diet) in the cirrhotic rats induced by CCl<SUB>4</SUB>, while in those fed with 25% casein (normal protein diet), no significant change of OCT was observed either in serum or in tissue.<BR>These results suggested followings:<BR>1) The predominant elevation of s-OCT and the increase of serum OCT/m-GOT ratio in liver cirrhosis indicate enzyme induction in urea cycle of the hepatocyte.<BR>2) The tendency of predominantly higher s-OCT activity in HCC with cirrhosis reflects the enzyme induction in cirrhotic liver.<BR>3) The increase of s-OCT/s-mGOT ratio in liver cirrhosis is suggestive of overload of nitrogen compounds and useful for prediction of hepatic encephalopathy.
- 社団法人 日本肝臓学会の論文