吲哚菁绿15 min滞留率在肝储备功能评估中的价值探讨

摘要

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.%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。