^(13)C嘧塞西啶呼气试验测量慢性肝病患者肝脏储备功能的临床研究

Measurement of liver functional capacity by means of ^(13)C-methacetin breath test in chronic liver diseases

目的探讨^(13)C-嘧塞西啶呼气试验与慢性肝病患者肝脏储备功能的关系。方法将40例各种肝病患者分为慢性肝炎组和肝硬化组,每组20例；按病因分为酒精性肝病组(16例)和病毒性肝病组(24例)；另选10例健康者为对照组；均做血生化、肝功能检测及^(13)C-嘧塞西啶呼气试验。结果在对照组(肝功能正常组),慢性肝炎组和肝硬化组的诸项指标中,血清白蛋白(ALB)、前白蛋白(PreALB)水平逐渐下降：总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)、凝血酶原时间(PT)、凝血酶原时间的国际标准化比值(INR)及终末期肝病模型评分(MELD)逐渐升高,^(13)C-嘧塞西啶呼气试验丰度(CUM30,CUM120,MVmax30)水平逐渐下降并且有显著性差异。按病因分组,酒精性肝病组和病毒性肝病组的以上数据无显著性差异。结论^(13)C-嘧塞西啶呼吸试验是评价肝病患者肝脏功能的安全有效的诊断工具。

Objective To investigate the clinical significance of ^3C-mithacetin breath tests for assessment and classification of live functional capacity. Methods Ten healthy volunteers served as a control group. Patients （test group） with different kinds of liver diseases were divided into 2 sub-groups based on chronic hepatitis and liver cirrhosis （n=20, respectively）. Patients in both groups were examined for liver function by a biochemical test and ^3C-mithacetin breath test. Results Index such as Albumin, pre-albumin in patients of the test group were significantly decreased compared with those in patients of control group. Index such as total bile acid, tolal bilirubin, direct bilirubin, prothrombin time, and prothrombin time of international rate in patients of the test gtoup were significantly in creased compared with those in patients of eontrol group. Score of model for end-stage liver disease in patients of the test group was signigicantly increased compared with that in patients of the control group. CUM30, CUM120, MVmax30 values in patients of the test group significantly decreased compared with those in patients of control group. There was no significant difference between alcoholic group and hepatitis group. Conclusions ^3C-methacetin breath test is a safe, effective method in assessment and classification of liver capacity.