肝循環動態に関する研究　第1編 肝疾患時における肝内酸素消費に関する研究

By means of catheterization of hepatic veins, hepatic oxygen consumption was estimated on patients with chronic viral hepatitis (37 cases), precirrhosis (4 cases) and cirrhosis of the liver (13 cases). The oxygen consumption was calculated from the difference of oxygen content between the hepatic artery and the hepatic vein multiplied with the total hepatic blood flow. The results werc as follows: 1. The oxygen content of the arterial blood showed no significant difference in groups of chronic hepatitis, precirrhosis and cirrhosis of the liver. 2. Similarly, the arterio-venous oxygen difference, as measured without any regard of hepatic shunt flow, did not differ significantly in those three groups. Decreased hepatic blood flow, therefore induced a decreased amount of hepatic oxygen consumption; the decrease of hepatic blood flow was not accompanied with the compensatory increase of the plausible arterio-venous oxygen difference. 3. The arterio-venous oxygen difference calculated with a reference to the influences of hepatic shunt flow was estimated by multiplication of arterio-venous oxygen difference to the ratio of total hepatic blood flow and effective hepatic blood flow. The difference was found to be increased in a majority of the cases of liver cirrhosis, indicating the oxygen extraction by the hepatic cells in cirrhosis was significantly increased. Conversely, oxygen saturation of non-shunted hepatic venous blood was markedly decreased in cirrhosis. Thus the increased oxygen extraction by the cirrhotic hepatic cells occured in the state of low oxygen tension. The hepatic oxygen consumption was found to be maintained as great as possible by increasing the arterio-venous oxygen difference calculated with a reference to the influence of hepatic shunt flow. 4. The increase of the arterio-venous oxygen difference calculated with a reference to the influence of hepatic shunt flow was closely related to the abnormalities of the hepatic hemodynamics, histological changes and hepatic disfunctions.

学位番号 甲第188号