리도카인 대사산물인 MEGX(Monoethyl-glycinexylidide)을 이용한 간기능 검사

Abstract

The quantitative assessment of preoperative liver function is essential since hepatic reserve function after hepatic resection has significant influence on the prognosis. But conventional liver function tests are limited in quantitating hepatic function and can only assess the presence or absence of hepatobiliary injury without reflecting the severity of the disease. More recently, measurements of hepatic lidocaine metabolism to its primary metabolite monoethylglycinexylidide(MEGX) taken by an automated fluorescent polarization immunoassay with a TDx analyzer(Abbott Laboratories, Diagnostic Division, North Chicago, IL) have demonstrated a means for a rapid and reproducible assessment of hepatic function. Therefore, to determine the clinical value of this lidocaine metabolite as a quantitative liver function test, we measured the serum MEGX concentration, 15 min after intravenous administration of single dose of lidocaine 1㎎/㎏) in 40 adults. The following side effects were recorded : dizziness(N=39), tinnitus(N=39), perioral numbness(N=3), and febrile sensation(N=1). These side effects were mild, disappearing within 5 minutes. 6 of 40 cases were excluded due to abnormal liver function and/or very low MEGX concentrations(less than 10 percentile). The peak MEGX concentration of 34 cases, 15 min after injection of lidocaine, was 431.8±14.74ng/㎖(men S.E) with the reference value between from 35.47 and 51.80 ng/㎖(25-75 percentile). The measurement of MEGX concentration, 15 min after lidocaine injection, may serve as a simple, safe, and rapid quantitative liver function test, but further prospective studies in cases with chronic hepatitis and primary hepatoma are needed in order to establish the cutoff level of MEGX concentration that can determine the abnormality.