AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;media...AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;median age,61 years;range:37-76 years).All patientswere enrolled in this study after obtaining written informed consent.Liver function was measured with tests measuring albumin(Alb),prothrombin time(PT),brain natriuretic peptide(BNP),branched amino acid and tyrosine ratio(BTR),branched chain amino acid(BCAA),tyrosine,ammonia(NH3),cholinesterase(Ch E),immunoreactive insulin(IRI),total bile acid(TBA),and the retention rate of indocyanine green 15 min after administration(ICG R15).Hepatic blood flow,hepatic arterial tissue blood flow(HATBF),portal venous tissue blood flow(PVTBF),and total hepatic tissue blood flow(THTBF)were simultaneously calculated using xenon computed tomography.RESULTS:PVTBF,HATBF and THTBF were 30.2±10.4,20.0±10.7,and 50.3±14.9 m L/100 m L/min,respectively.Alb,PT,BNP,BTR,BCAA,tyrosine,NH3,Ch E,IRI,TBA,and ICG R15 were 3.50±0.50 g/d L,72.0%±11.5%,63.2±56.7 pg/m L,4.06±1.24,437.5±89.4μmol/L,117.7±32.8μmol/L,59.4±22.7μg/d L,161.0±70.8 IU/L,12.8±5.0μg/d L,68.0±51.8μmol/L,and 28.6%±13.5%,respectively.PVTBF showed a significant negative correlation with ICG R15(r=-0.468,P<0.01).No significant correlation was seen between ICG 15R,HATBF and THTBF.There was a significant correlation between PVTBF and Alb(r=0.2499,P<0.05),and NH3 tended to have an inverse correlation with PVTBF(r=-0.2428,P=0.0894).There were also many significant correlations between ICG R15 and liver function parameters,including Alb,NH3,PT,BNP,TBA,BCAA,and tyrosine(r=-0.2156,P<0.05;r=0.4318,P<0.01;r=0.4140,P<0.01;r=0.3610,P<0.05;r=0.5085,P<0.001;r=0.4496,P<0.01;and r=0.4740,P<0.05,respectively).CONCLUSION:Our investigation showed that there is a close correlation between liver function and hepatic blood flow.展开更多
目的:比较乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)、胆碱酯酶(cholinesterase,CHE)和吲哚氰绿15min滞留率(indocyanine green retention rate at 15min,ICGR15)在慢性乙型肝炎组、肝硬化代偿组、肝硬化失代偿组的水平,并...目的:比较乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)、胆碱酯酶(cholinesterase,CHE)和吲哚氰绿15min滞留率(indocyanine green retention rate at 15min,ICGR15)在慢性乙型肝炎组、肝硬化代偿组、肝硬化失代偿组的水平,并研究3者之间的相关性.方法:观察95例慢性乙型肝炎病毒感染患者,按病情分为慢性乙型肝炎组、肝硬化失代偿组和肝硬化代偿组3组.分别检测血清HBsAg、CHE、ICGR15,评价3组间观察指标的差异及相关性.结果:3组间HBsAg水平3.44lgIU/mL±0.55lgIU/mL、3.14lgIU/mL±0.39lgIU/mL、2.76lgIU/mL±0.55lgIU/mL有显著差异(P<0.05);慢性乙型肝炎组与肝硬化失代偿组CHE(6631.37U/L±1907.18U/Lvs4838.51U/L±2134.35U/L,P<0.05)、ICGR15(9.77%±5.57%vs27.69%±13.30%,P<0.05)有显著性差异.相关分析显示各组间CHE和ICGR15均呈负相关,r分别为-0.401、-0.625、-0.444,P<0.05;肝硬化代偿组和失代偿组HBsAg与CHE呈正相关,r分别为0.449、0.407,P<0.05;肝硬化代偿组和失代偿组HBsAg与ICGR15呈负相关,r分别为-0.498、-0.757,P<0.05.结论:随着乙型肝炎向肝硬化进展,HBsAg、CHE水平逐渐降低,ICGR15水平逐渐升高.肝硬化阶段HBsAg与ICGR15呈负相关,与CHE呈正相关,提示HBsAg可能与肝脏残余有效肝细胞量呈正比.且肝硬化阶段CHE和ICGR15呈负相关,因此一定程度上可通过HBsAg、CHE来反映肝硬化患者ICGR15水平.展开更多
目的通过吲哚菁绿清除试验评估HBV相关肝病患者肝脏储备功能,比较吲哚菁绿试验15分钟滞留率（indocyanine green retention rate at 15 minutes,ICG R15）与Child-Turcotte-Pugh score（CTP）分级和终末期肝病模型评分（the model for e...目的通过吲哚菁绿清除试验评估HBV相关肝病患者肝脏储备功能,比较吲哚菁绿试验15分钟滞留率（indocyanine green retention rate at 15 minutes,ICG R15）与Child-Turcotte-Pugh score（CTP）分级和终末期肝病模型评分（the model for end-stage liver disease,MELD）对乙型肝炎肝硬化患者预后的评估能力。方法选取56例慢性乙型肝炎（chronic hepatitis B,CHB）和144例乙型肝炎肝硬化患者进行ICG R15检测,采用t检验比较CHB与乙型肝炎肝硬化两者ICG R15的差别,用Spearman相关性分析乙型肝炎肝硬化患者ICG R15与MELD评分及CTP分级的关系;通过受试者工作特征（ROC）曲线法分析ICG R15与MELD评分对肝硬化预后的评估能力。结果56例CHB患者ICG R15为1.40~9.50,平均值为4.43±2.19;144例乙型肝炎肝硬化患者ICG R15为2.40~60.00,平均值为22.80±16.00,显著高于CHB组,差异有统计学意义（P〈0.01）。CTP分级：A级患者70例,MELD评分4.99±2.76;B级患者54例,MELD评分6.24±4.69;C级患者20例,MELD评分11.71±3.77。在评价肝功能方面ICG R15与MELD评分及CTP分级呈正相关（r=0.414、r=0.67,P〈0.01）。ICG R15评估乙型肝炎肝硬化患者预后的曲线下面积（AUC）为0.903,最佳截点为9.55%,敏感度为71.5%,特异度为100%。MELD评分AUC为0.634,最佳截点为7.00,敏感度为36.8%,特异度89.3%。结论吲哚菁绿试验能动态反映肝脏储备功能,与MELD评分结合能更好地反映肝脏功能及评估患者预后。展开更多
文摘AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;median age,61 years;range:37-76 years).All patientswere enrolled in this study after obtaining written informed consent.Liver function was measured with tests measuring albumin(Alb),prothrombin time(PT),brain natriuretic peptide(BNP),branched amino acid and tyrosine ratio(BTR),branched chain amino acid(BCAA),tyrosine,ammonia(NH3),cholinesterase(Ch E),immunoreactive insulin(IRI),total bile acid(TBA),and the retention rate of indocyanine green 15 min after administration(ICG R15).Hepatic blood flow,hepatic arterial tissue blood flow(HATBF),portal venous tissue blood flow(PVTBF),and total hepatic tissue blood flow(THTBF)were simultaneously calculated using xenon computed tomography.RESULTS:PVTBF,HATBF and THTBF were 30.2±10.4,20.0±10.7,and 50.3±14.9 m L/100 m L/min,respectively.Alb,PT,BNP,BTR,BCAA,tyrosine,NH3,Ch E,IRI,TBA,and ICG R15 were 3.50±0.50 g/d L,72.0%±11.5%,63.2±56.7 pg/m L,4.06±1.24,437.5±89.4μmol/L,117.7±32.8μmol/L,59.4±22.7μg/d L,161.0±70.8 IU/L,12.8±5.0μg/d L,68.0±51.8μmol/L,and 28.6%±13.5%,respectively.PVTBF showed a significant negative correlation with ICG R15(r=-0.468,P<0.01).No significant correlation was seen between ICG 15R,HATBF and THTBF.There was a significant correlation between PVTBF and Alb(r=0.2499,P<0.05),and NH3 tended to have an inverse correlation with PVTBF(r=-0.2428,P=0.0894).There were also many significant correlations between ICG R15 and liver function parameters,including Alb,NH3,PT,BNP,TBA,BCAA,and tyrosine(r=-0.2156,P<0.05;r=0.4318,P<0.01;r=0.4140,P<0.01;r=0.3610,P<0.05;r=0.5085,P<0.001;r=0.4496,P<0.01;and r=0.4740,P<0.05,respectively).CONCLUSION:Our investigation showed that there is a close correlation between liver function and hepatic blood flow.
文摘目的:比较乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)、胆碱酯酶(cholinesterase,CHE)和吲哚氰绿15min滞留率(indocyanine green retention rate at 15min,ICGR15)在慢性乙型肝炎组、肝硬化代偿组、肝硬化失代偿组的水平,并研究3者之间的相关性.方法:观察95例慢性乙型肝炎病毒感染患者,按病情分为慢性乙型肝炎组、肝硬化失代偿组和肝硬化代偿组3组.分别检测血清HBsAg、CHE、ICGR15,评价3组间观察指标的差异及相关性.结果:3组间HBsAg水平3.44lgIU/mL±0.55lgIU/mL、3.14lgIU/mL±0.39lgIU/mL、2.76lgIU/mL±0.55lgIU/mL有显著差异(P<0.05);慢性乙型肝炎组与肝硬化失代偿组CHE(6631.37U/L±1907.18U/Lvs4838.51U/L±2134.35U/L,P<0.05)、ICGR15(9.77%±5.57%vs27.69%±13.30%,P<0.05)有显著性差异.相关分析显示各组间CHE和ICGR15均呈负相关,r分别为-0.401、-0.625、-0.444,P<0.05;肝硬化代偿组和失代偿组HBsAg与CHE呈正相关,r分别为0.449、0.407,P<0.05;肝硬化代偿组和失代偿组HBsAg与ICGR15呈负相关,r分别为-0.498、-0.757,P<0.05.结论:随着乙型肝炎向肝硬化进展,HBsAg、CHE水平逐渐降低,ICGR15水平逐渐升高.肝硬化阶段HBsAg与ICGR15呈负相关,与CHE呈正相关,提示HBsAg可能与肝脏残余有效肝细胞量呈正比.且肝硬化阶段CHE和ICGR15呈负相关,因此一定程度上可通过HBsAg、CHE来反映肝硬化患者ICGR15水平.
