PDD法吲哚氰绿潴留试验评估肝硬化与肝癌肝功能的临床意义

目的 探讨脉动色素浓度测定(PDD)吲哚氰绿(ICG)潴留试验对于评价肝硬化与肝癌肝储备功能的临床价值.方法 选取89例肝炎肝硬化患者和40例原发性肝癌患者,以PDD法测定ICG 15 win潴留率(ICGR15)及常规临床指标CHE、PAB、ALB、PTA、TBA;比较ICGRl5与以上临床指标对肝功能评价的意义,并各指标进行相关性分析.结果 (1)ICGR15、CHE、TBA、ALB、PTA在Child-Pugh A、B、C级3组比较,差异均有统计学意义(F=40.975,13.397,27.448,9.544,20.421,P<0.05),PAB在B级与A级、C级与A级之间差异有统计学意义(F=16.627,P<0.05).(2)肝炎肝硬化患者ICGRl5和TBA随Child-Push分值(C-P值)增加而递增,PTA则递减;ICGR15分别在C-P值5分与7分,9分与10分比较,差异有统计学意义(F=12.635,P<0.05).(3)ICGR15值与常用临床指标作相关性分析得出,与ICGR15值相关性最好的为TBA(r=0.605),其次为PTA、CHE、PAB、ALB(r=-0.598,-0.565,-0.537,-0.424).结论 PDD法ICGRl5与常规临床指标存在良好相关性,且明显优于常规肝功能指标,CHE、TBA也能够客观地评价肝储备状况.

ICG clearance determined by pulse dye densitometry for liver reserve in hepatic cirrhosis and primary liver carcinoma

Objective To investigate the efficacy of ICG clearance test for hepatic reserve function in patients with hepatic cirrhosis and primary liver carcinoma by pulse dye deusitometry (PDD). Methods Eighty-nine patients with hepatic cirrhosis and forty patients with primary hver carcinoma were enrolled in this study. All patients were classified by Child-Pugh grade. The value of indocyanin green retention at 15 min (ICGRI5) was measured by PDD. Biochemical parameters including CHE, PAB, ALB, PTA and TBA were also examined. Correlation analysis between ICGR15 and those indexes were conducted. Results (1) ICGR15, CHE, TBA, ALB, PTA among Child-Pugh A, B, C in all patients were significantly different (P < 0.05). PAB between Child-Pugh B and A group, C and B group was significantly different (P < 0.05). (2)Increased level of ICGR15 and TBA positively correlated with Child-Pugh scores, while negatively correlated with the level of PTA. The difference of ICGRI5 between Child-Pugh score 5 and score 7, score 9 and score 10 were all significant (P <0.05). (3) The correlation between ICGR15 and other clinical markers is significant. The clinical marker with the best correlation was TBA (r=0.605), was the parameter in most significantly correlated with ICGR15 followed by PTA, CHE, PAB, and ALB (r= -0.598, -0.565, -0.537, -0.424). Conclusion There was good correlation between the clinical markers and the value of ICGR15 which demonstrate superiority to the other indexes. The data also suggested that CHE, TBA, could be used in evaluating liver reserve function.