吲哚菁绿清除试验在干细胞移植患者肝脏储备功能评估中的应用价值

The application value of indocyanine green clearance test in assessment of liver reserve function for patients with stem cell transplantation

目的探讨吲哚菁绿清除试验在干细胞移植患者肝脏储备功能评估中的应用价值,并观察干细胞移植对终末期肝病患者肝脏储备功能的影响。方法 31例终末期肝病患者随机分为两组,对照组(14例)采用常规方法治疗,治疗组(17例)在常规治疗基础上行干细胞移植。移植后应用吲哚菁绿清除试验检测肝脏储备功能,比较两组患者移植前与移植后肝脏储备功能、肝脏合成功能及健康状况量化评分的变化。结果移植3个月后治疗组肝脏储备功能指标如ICGK和ICGR15均优于治疗前(P<0.05),与对照组比较,肝脏储备功能变化无差异性(P>0.05),两组EHBF值在治疗前后均无明显变化(P>0.05);移植3个月后治疗组白蛋白、胆碱酯酶、凝血酶原时间等均优于治疗前(P<0.05),与对照组比较,白蛋白升高更为明显(P<0.05),两组胆碱酯酶与凝血酶原时间变化无差异性(P>0.05);治疗组自理能力及健康状况均优于干细胞移植前(P<0.05),也优于对照组(P<0.05)。结论吲哚菁绿清除试验可用于干细胞移植患者肝脏储备功能的评估,安全可靠;干细胞移植能在一定程度上改善患者肝脏储备功能、合成功能和近期预后,值得临床推广应用。

Objective To discuss the application value of indocyanine green clearance test in assessment of hepatic reserve function for patients with stem cell transplantation, and to observe the influence of stem cell transplantation on hepatic reserve function for patients with end-stage liver disease. Methods 31 patients with end-stage liver disease were randomly divided into 2 groups. Control group （14 cases） was treated with routine methods, and treatment group （ 17 cases） was treated with stem cell transplantation on base of routine methods. Liver reserve function of all patients was detected by indocyanine green clearance test after transplantation. The changes of liver reserve function, hepatic synthet- ic function and quantified score of health status in 2 groups were compared before and after transplantation. Results The indicators of liver reserve function, such as ICGK and ICGR15, in treatment group three months after transplantation were better than before treatment（P 〈 0.05） , compared with the control group, the changes of liver reserve function in treatment group had no difference （P 〉 0.05 ） , the value of EHBF in 2 groups had no significant change before and after the treatment （P 〉 0.05） ; The choliaesterase, albumin, prothrombin time indicators in treatment group 3 months after transplantation were better than befl）re treatment （P 〈 0.05 ） , compared with the control group, serum albumin in- creased more than those in the control group （P 〈 0.05 ） , the changes of cholinesterase and prothrombin time in the 2 groups had no difference（P 〉 0.05） ; The self-care ability and health status in treatment group 3 months after treatment were better than before stem cell transplantation （P 〈 0.05）, but also better than the control group （P 〈 0.05 ）. Con- clusion Indocyanine green clearance test can be used in assessment of hepatic reserve function for patients with stem cell transplantation, safe and reliable; Liver reserve function, synthetic function and short-term prognosis of patients with end-stage liver disease can be improved by stem cell transplantation. It should be worthy of clinical application.