IRIS^13C-美沙西汀呼气试验在肝硬化患者中的应用及评价

The application and valuation of IRIS^(13) C-methacetin breath test in patients with cirrhosis.

目的探讨13C-美沙西汀呼气试验在评估肝硬化患者肝功能状况中的临床应用价值。方法42例肝硬化患者,根据传统Child-Pugh分级分为A、B、C三组。均做常规肝功能生化检测及3C-美沙西汀呼气试验。结果随着Child-Pugh分级的加重,呼气试验参数值MVmax40(40分钟前代谢速率峰值与正常值(27)的比值)、CUM40(40分钟CO2累积呼出丰度与正常值(12)的比值)和CUM120(120分钟CO2累积呼出丰度与正常值(28)的比值)显著降低,组间差异有显著性(P<0.05)。三参数值与Child-Pugh分级计分及一些临床肝功能检测结果显著相关(P<0.05)。结论IRIS13C(红外线同位素13C)-美沙西汀呼气试验能准确反应肝脏储备和代偿功能,是传统Child-Pugh分级及临床肝功能生化检测评估肝功能的有益补充,具有即时、安全、有效、定量、无创的特点。

Objective To investigate the clinical value of ^13C- methacetin breath test in the assessment of liver function in patients with cirrhosis. Methods 42 patients with liver cirrhosis were divided into three groups, 16 patients in Child - pugh classification A, 21in B and 5 in C. All received liver functional test and ^13C- methacetin breath test at the same time. Results According to the severity of Child - pugh classification, the parameters of breath test ： MVmax40（a ratio between the maximum velocity before 40 minutes and the standard （27）, CUM40 （a ratio between the cumulative percentage ^13C dose recovered over 40 minutes and the standard （12） and CUM120 （a ratio between the cumulative percentage ^13C dose recovered over 120 minutes and the standard （28）） were obviously reduced. The difference of them among these groups was significant （P 〈 0. 05 ）. The three parameters were significantly correlated with Child - pugh classification score and other clinical standard liver function tests （ P 〈 0. 05 ）. Conclusion ^13C- methacetin breath test can react to the liver functions of compensation and reservation actually. It is a helpful supplement technique of Child - pugh classification and clinical standards liver function tests, it is a test of instant, safe, effective, quantitative and non - invasive.