^(13)C-嘧塞西啶呼气试验测定肝硬化患者肝脏储备功能的临床价值

Clinical Value of Detecting Liver Reserve Function in Patients with Liver Cirrhosis by ^(13)C-Mithacetin Breath

目的探讨^(13)C-嘧塞西啶呼气试验(^(13)C-MBT)测定肝硬化患者肝脏储备功能的临床价值。方法选择2013年1月至2015年1月咸阳市中心医院就诊的50例肝硬化患者作为肝硬化组,无肝硬化慢性肝炎患者50例作为慢性肝炎组,选择同期进行体格检查的健康者30例作为对照组。3组研究对象均进行^(13)C-MBT,比较3组^(13)C-MBT各项参数差异,同时对Child-Pugh分级肝硬化患者的^(13)C-MBT各项参数进行比较。结果肝硬化组患者13CO2丰度(DOB)峰值时间[(47±18)min]、代谢速率(MV)峰值时间[(47±12)min]明显晚于慢性肝炎组[(32±9、32±11)min]和对照组[(20±7、21±6)min](P<0.05),且慢性肝炎组明显晚于对照组(P<0.05);肝硬化组患者DOB峰值、MV峰值、MVmax40、累积丰度(CUM)40、CUM120、肝储备能力明显低于慢性肝炎组和对照组(P<0.05),且慢性肝炎组明显低于对照组(P<0.05)。Child B级和Child C级的DOB峰值时间、MV峰值时间多于Child A级,且Child C级多于Child B级,差异有统计学意义(P<0.05);Child B级和Child C级的DOB峰值、MV峰值、MVmax40、CUM40、CUM120低于Child A级,且Child C级低于Child B级,差异有统计学意义(P<0.05)。结论^(13)C-MBT各项参数均能有效区分肝硬化患者、慢性肝炎患者与健康人群,对测定肝硬化患者肝脏储备功能具有重要的临床价值。

Objective To investigate the clinical value of detecting liver reserve function in patients with liver cirrhosis by^（13）C-mithacetin breath test（^（13）C-MBT）. Methods Total of 50 patients with liver cirrhosis in Xianyang Central Hospital were included in liver cirrhosis group,50 patients with chronic hepatitis but without cirrhosis were included in chronic hepatitis group. In addition,30 healthy persons receiving physical examination during the same period were included in control group. The above three groups underwent^（13）C-MBT,then the parameters of^（13）C-MBT between the three groups were compared,meanwhile,parameters of^（13）C-MBT in patients with different Child-Pugh grades of liver cirrhosis were compared. Results DOB peak time[（ 47 ± 18） min],MV peak time [（ 47 ± 12） min] of the cirrhosis group were later than the chronic hepatitis group[（ 32 ± 9） min,（ 32 ± 11） min] and control group[（ 20 ± 7） min,（ 21 ± 6） min]（ P 〈0. 05）,and chronic hepatitis group was significantly later than that of the control group（ P 〈0. 05）;DOB peak,MV peak,MVmax40,CUM40,CUM120,liver reserve ability of the cirrhosis group were lower than the chronic hepatitis group and control group（ P 〈0. 05）,and chronic hepatitis group was significantly lower than that of the control group（ P 〈0. 05）. DOB peak time,MV peak time of the Child B and Child C were more than Child A,and Child C were more than Child B（ P 〈0. 05）; DOB peak,MV peak,MVmax40,CUM120,CUM40 of the Child B and Child C were lower than Child A,and the Child C were lower than Child B（ P 〈0. 05）. Conclusion^（13）C-MBT can be used to effectively distinguish the liver cirrhosis patients from chronic hepatitis patients and healthy population,thus is of great clinical value for determination of the liver reserve function of patients with liver cirrhosis.