吲哚菁绿(ICG)清除试验评估肝病患者肝脏储备功能的相关研究

CORRELATION STUDY OF INDOCYANINE GREEN(ICG)CLEARANCE TEST IN EVALUATING LIVER RESERVE FUNCTION IN PATIENTS WITH LIVER DISEASE

目的通过吲哚菁绿(ICG)清除试验评估肝病患者肝脏储备功能,探讨ICG清除试验与Child-Turcotte-Pugh(CTP)分级和终末期肝病模型(MELD)评分评价肝功能之间的关系。方法收集济宁市第一人民医院2018年1月~2019年1月住院的乙型肝炎肝硬化46例,肝癌63例,进行ICG清除试验,计算患者的ICG血浆清除率值(K值)、ICG 15 min滞留率(ICG R15),分析患者CTP分级和MELD评分。组间比较采用方差分析,进一步两两比较采用LSD-t检验;相关性比较采用Spearman等级相关性分析。结果CTP分级:A级84例,B级25例。随着CTP分级及MELD分级升高,ICG R15逐渐增高,而K值则逐渐降低,差异均有统计学意义(P值均分别为0.001、0.005)。在评价肝功能方面ICG R15与CTP分级及MELD评分呈正相关(r值分别为0.677、0.8439,P值均<0.01),K值与CTP分级及MELD评分呈负相关(r值为-0.814,-0.5978)。结论ICG清除试验能够准确动态反应肝脏储备功能,ICG R15及K值可辅助CTP分级及MELD评分评估肝脏储备功能。

Objective:To evaluate the liver reserve function of patients with liver disease by indocyanine green(ICG)clearance test,and to explore the relationship between ICG clearance test and Child-Turcotte-Pugh(CTP)classification and end-stage liver disease model(MELD)scores for evaluating liver function.Methods:46 patients with hepatitis B cirrhosis and 63 patients with liver cancer who received treatment in the Jining First People’s Hospital from January 2018 to January 2019 were performed with the ICG clearance test,ICG plasma clearance value(K value)and ICG 15min retention rate(ICG R15)were calculated,then CTP and MELD scores were analyzed.Variance analysis was used for comparison among groups,and LSD-t test was used for further pairwise comparison.Correlation comparison was performed using Spearman rank correlation analysis.Results:CTP classification included 84 cases of grade A and 25 cases of grade B.With the increase of CTP grade and MELD grade,ICG R15 gradually increased,while K value decreased gradually,the differences all had statistically significant(P=0.001,0.005).ICG R15 was positively correlated with CTP grade and MELD scores(r=0.677,0.8439,P<0.01),and K value was negatively correlated with CTP grade and MELD scores(r=-0.80,-0.5978).Conclusion:The ICG clearance test can reflect the liver reserve function accurately and dynamically.ICG R15 and K values can assist CTP and MELD scores in assessing liver reserve function.