天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (9): 1136-1138.doi: 10.11958/20150429

• 临床研究 • 上一篇    下一篇

吲哚菁绿 15 min 滞留率在肝储备功能评估中的价值探讨

田瑞民,刘国旺,魏巍,唐克城   

  1. 天津市第二人民医院重症肝病科（邮编 300192）
  • 收稿日期:2015-12-25 修回日期:2016-04-05 出版日期:2016-09-15 发布日期:2016-09-28
  • 通讯作者: 唐克诚 E-mail:trm2008@126.com
  • 作者简介:田瑞民（1982）， 男， 医师， 主要从事重症肝病临床治疗工作

The study on the value of stagnation rate at 15 min of indocyanine green for assessment of hepatic reserve function

TIAN Ruimin, LIU Guowang, WEI Wei, TANG Kecheng△   

  1. Chronic Servere Hepatitis Department, Tianjin Second People’ s Hospital, Tianjin 300192, China
  • Received:2015-12-25 Revised:2016-04-05 Published:2016-09-15 Online:2016-09-28
  • Contact: TANG Kecheng E-mail:trm2008@126.com

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摘要： 目的 探讨吲哚菁绿 15 min 滞留率（ICGR15）评估肝储备功能的价值。 方法 肝病患者 185 例， 其中肝衰竭组 45 例、肝硬化组 90 例（Child A、B 及 C 分别为 16、26 及 48 例）、急性肝炎组 20 例、慢性肝炎组（轻、中度）30 例。 比较各组的 ICGR15 表达水平差异。 比较肝衰竭组治疗前及治疗后 1 个月时 ICGR15、总胆红素（TBIL）、白蛋白（ALB）、凝血时间（PT）的变化。 急性肝炎组治疗前及治疗后 1 个月丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、 TBIL 及 ICGR15 水平的变化。 结果 肝衰竭组、肝硬化组、急性肝炎组、慢性肝炎组 ICGR15（%）分别为 56.3±14.7、 28.9±9.6、 22.4±6.8、 13.7±2.3， 呈逐渐下降趋势（F=125.317， P＜ 0.05）。 其中 ， 肝硬化组 Child A 、 B 及 C 级别组 ICGR15（%）水平分别为 17.3±5.4、25.7±7.5、34.5±7.3， 呈逐渐升高趋势（P＜ 0.05）。 治疗后１个月时， 肝衰竭组 TBIL、 PT 及 ICGR15 均低于治疗前， 急性肝炎组 ALT、AST、TBIL 及 ICGR15 均低于治疗前（P＜ 0.05）。 结论 ICGR15 可以反映肝功能储备情况， 且不受 ALB、鲜血浆应用的影响， 弥补了 ALB、PT 检查的不足。

关键词: 肝病, 肝硬化, 肝炎, 肝衰竭, 肝储备功能, 吲哚菁绿

Abstract: Objective To observe the clinical value of indocyanine green retention rate at 15 minutes (ICGR15) in the evaluation of hepatic functional reserve. Methods A total of 185 patients with liver disease, including 45 cases of liver failure, 90 cases of cirrhosis (child A, B and C, respectively), 20 cases of acute hepatitis, 30 cases of chronic hepatitis (mild, moderate). Expression levels of ICGR15 were compared between groups. Values of ICGR15, total bilirubin (TBIL), albumin (ALB), blood coagulation time (PT) were compared before treatment and one month after treatment in hepatic failure group. Levels of alanine aminotransferase (ALT), aspertate aminotransferase (AST), TBIL and ICGR15 were compared before treatment and 1 month after treatment in acute hepatitis group. Results Levels of ICGR15 (%) were 56.3±14.7, 28.9±9.6, 22.4±6.8 and 13.7±2.3 in liver failure group, liver cirrhosis group, acute hepatitis group and chronic hepatitis group, which showed a gradual downward trend (F=125.317, P < 0.05). Among them, the levels of ICGR15 (%) were 17.3±5.4, 25.7±7.5 and 34.5±7.3 in Child A, B and C groups of liver cirrhosis group, which showed a gradual upward trend (P < 0.05). After one month treatment, levels of TBIL, PT and ICGR15 were significantly lower than T helper 17 cells; intima-media thickness before the treatment in liver failure group. The levels of ALT, AST, TBIL and ICGR15 were significantly lower after treatment than those before treatment in acute hepatitis group (P < 0.05). Conclusion ICGR15 can reflect hepatic reserved function, which is not affected by the application of albumin and fresh plasma, and makes up the deficiency of PT and ALB detection.

Key words: liver diseases, liver cirrhosis, hepatitis, liver failure, liver reserve function, indocyanine green