MONOETHYLGLYCINEXYLIDIDE FORMATION MEASUREMENT AS A HEPATIC-FUNCTION TEST TO ASSESS SEVERITY OF CHRONIC LIVER-DISEASE

Objectives: Monoethylglycinexylidide (MEGX) is the main lidocaine meta bolite and its formation depends on liver microsomal activity. MEGX fo rmation was studied in comparison with the histological scare of chron ic hepatitis and with the clinical score (Child-Pugh) of cirrhosis. Fu rthermore, we evaluated its ability to distinguish between the two liv er diseases. Methods: We studied 284 patients: 130 with chronic hepati tis (on the basis of the histological activity index, 45 had mild chro nic hepatitis, 54 had moderate chronic hepatitis, and 31 had chronic h epatitis with cirrhosis) and 154 with cirrhosis (49 Child-Pugh's class A, 78 class B, and 27 class C). MEGX formation was evaluated 15, 30, and 60 min after lidocaine administration, Results: MEGX formation sho wed a stepwise decline corresponding to worsened liver disease. MF,GX values were related both to the histological score in chronic hepatiti s and to the clinical score in cirrhosis. Significantly lower values w ere found in females < 50 yr of age than in males of the same age. The MEGX test showed great efficacy in discriminating between chronic hep atitis and cirrhosis compared with standard liver tests. Conclusions: Measurement of MEGX formation proved to be a safe test, allowing us to show that functional subgroups can be identified both in chronic hepa titis and in cirrhosis. Thus, this test could integrate both the histo logical grading of chronic hepatitis and the clinical staging of cirrh osis.