吲哚菁氯潴留率对食管曲张静脉破裂出血的预后评估

Retention Rate of Indocyanine Green for Predicting the Prognosis of Cirrhotic Patients with Esophageal Varices Bleeding

目的分析吲哚菁氯潴留率(ICG-R15)与肝硬化食管胃底曲张静脉破裂出血患者预后的关系。方法应用吲哚菁氯排泄试验检测108例肝硬化食管胃底曲张静脉破裂出血患者,并根据ICG-R15分为3组,比较3组间1年内再出血率的差异。并用受试者工作特征曲线分析ICG-R15、终末期肝病模型(MELD)评分以及Child-Pugh评分预测肝硬化食管胃底曲张静脉破裂再出血的敏感度、特异度、约登指数及曲线下面积(AUROC),分析各评分标准对再出血的预见能力。结果食管胃底静脉曲张破裂出血患者的再出血率随着ICG-R15的增高而增高,3组间有显著差异(P<0.05)。ICG-R15在判断再出血的敏感度最高达97.4%,特异度最高达75.0%,AUROC最大。结论 ICG-R15有助于预测肝硬化食管胃底曲张静脉破裂出血患者的再出血率。

Objective To evaluate the re-bleeding rate in patients with cirrhosis esophageal varices bleeding using retention rate of indoeyanine green at fifteen minutes（ICG - R15）. Methods A total of 108 patients were tested with ICG - RIS. Based on the ICG - R15, all patients were divided into three groups. The difference of the re - bleeding rate in one year was compared among the three groups. And for assessing the value of predicting re - bleeding rate in cirrhotic patients with esophageal varices bleeding, the ICG - R15, MELD score and Child -Pugh score were calculated and evaluated by calculating receiver operator characteristic （ROC）curves, the sensitivity,the specificity,the Youden Index and the area under the AUROC curve. Results The incidence of re - bleeding was significantly different among the three groups with ICG - R15 test （P 〈 0.05）. The ICG - R15 had sensitivity of 97.4% , specificity of 75.0% and the largest AUROC for predicting the incidence of re - bleeding in patients with cirrhosis esophageal variees bleeding. Conclusion The ICG - R15 is a good parameter for predicting the prognosis of cirrhotic patients with esophageal variees bleeding.