R15指标和利用16排CT测评肝储备功能相关性研究

目的ICG清除试验（DDG分析仪检测法）是测定肝脏储备功能的新方法。本文旨在明确DDG检测在测定肝脏储备功能上的准确性，并讨论和评价基于DDG检测的肝脏储备功能与基于螺旋CT体积测定的半肝切除术后肝脏再生情况与肝脏储备功能的相关性意义。方法本研究收集了152例原发性肝癌患者的病例及随访资料。对每例患者于规则性半肝切除术前通过ICG清除试验检测测定ICG 15min滞留率（R15），并于术前及术后对其进行16层螺旋CT扫描，并测定肝脏体积、残余肝体积，求出残余肝脏术后1个月增殖率以代表残余肝再生能力。同时比较R15和残余肝术后1个月增殖率的相关性。结果所有患者均能在6-8min内ICG清除试验检测，检测过程中未发现明显的药物副作用及意外情况。本研究原发性肝癌病例中129例患者合并有不同程度的肝硬化，另22例患者合并慢性肝炎，但无明显肝硬化。合并肝硬化组与未合并肝硬化组间R15值差异均具有统计学意义。经相关性分析得出，R15值与Child-Pugh分级评分之间具有良好相关性。残余左半肝组和残余右半肝组再生增长率与DDG R15值之间均具有相关性。结论ICG清除试验指标（R15）能很好的反映原发性肝癌患者的肝储备功能；R15的数值与肝脏的再生有一定的相关性。

Objective ICG cleaning test （DDG analysis detecting method） is a new method to measure hepatic reservingfunction. The aim of the paper is to identify the accurate degree of the method of the DDG which is used to measure hepatic reserving function, and to discuss the relation between the method by DDG and the spiral CT method which also can be used to evaluate hepatic reserving function through determining the volume of the liver. Method 152 primary hepatic carcinoma patients consisted of the study group. Every patient underwent the DDG test （ICG cleaning test, Index is R15） and the 16 slices spiral CT measurement which included the volume of the total hepatic lobe, the residue lobe after precise hepatic exairesis. We got the hepatic growth rate which represented the liver regeneration capacity after the operation about one month. Meanwhile the relationship between the R15 and the regeneration capacity of the residue hepatic lobe. Result All of patients underwent the ICG test in six to eight minutes. No any drug side effect and emergency was detected during the test. 129 patients had distinct degree of the hepatic cirrhosis, and the other 22 ones had chronic hepatitis but no obvious hepatic cirrhosis. The distinction of the R15 in the hepatic cirrhosis group and the non - hepatic cirrhosis group had statistical significance. Through the dependability research, there was perfect relationship between the R15 and Child - Pugh. The relation between the hepatic growth rate of the residue of the left or right hepatic lobe and R15 existed. Conclusion R15 from ICG cleaning test can well represent the hepatic reserving function of the patients with primary hepatic carcinoma. There is relationship between the R15 and the hepatic regeneration capacity.