ICGR15在肝硬化断流术前评估肝脏储备功能的应用价值

目的 探讨吲哚菁绿试验15 min滞留率(ICGR15)在评估肝硬化断流术前肝脏储备功能的应用价值.方法 回顾性分析我院收治的75例肝硬化行断流术的患者,Child - Pugh A级患者55例,Child - Pugh B级患者20例.手术方式均为贲门周围血管离断术.对Child - Pugh A、B级两组患者术前测定的ICGR15及肝功能良好组和肝功能不全组间年龄、ALT、TBil、PT、Alb、ICGR15值、Child - Pugh评分进行比较,并应用ROC曲线评价ICGR15值的评估价值.结果 Child - Pugh A、B级两组ICGR15值分别为(17.98±12.12)％、(34.19 ±9.90)％,两组间差异具有统计学意义(P＜0.01);肝功能良好组和肝功能不全组间ICGR15值、Child - Pugh评分差异存在统计学意义(P＜0.01),年龄、ALT、TBil、PT、Alb差异无统计学意义(P＞0.01);ROC曲线下面积为0.971,差异有统计学意义(P =0.000).结论 ICGR15值是肝硬化断流术前评估肝脏储备功能较好的指标.

Clinical value of ICGR15 for assessing hepatic reserving function in liver cirrhosis patients after pericardial devascularization

Objective To investigate the indocyanine green retention rate at fifteen minutes(ICGR15) to assess hepatic reserving function in liver cirrhosis patients after pericardial devascularization.Methods The data of 75 patients with liver cirrhosis who were treated surgically with pericardial devascularization(by Akoi’s disconnective operation) in our hospital from 2010-2012 were retrospectively collected.Among these patients,55 had a Child-Pugh score of A and 20 had a Child-Pugh score of B.The values of ICGR15 were compared between the groups of Child-Pugh A patients and Child-Pugh B patients.Statistical correlations of liver functions or ICGR15 values with age,alanine aminotransferase(ALT),total bilirubin(TBil),prothrombin time(PT),and albumin(Alb) were evaluated.The appraisal value of ICGR15 was determined by the receiver operating characteristic(ROC) curve.Results The values of ICGR15 were significantly higher in the Child-Pugh A group than in the Child-Pugh B group (17.98±12.12%) vs.(34.19±9.90)%,P<0.01].The values of ICGR15 and Child-Pugh classification were statistically different between the two groups for different liver function conditions(P<0.01),but there was no significant differences in age,ALT,TBil,PT,or Alb(P>0.01).The area under the curve for ICGR15 values was 0.971 with a high statistical significance(P=0.000).Conclusion The ICGR15 is a good indicator of hepatic reserving function in patients with liver cirrhosis who have been treated with Akoi′s disconnective operation.