Hashimoto M, Watanabe G
Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
Hepatogastroenterology. 2000 Nov-Dec;47(36):1669-74.
BACKGROUND/AIMS: Because the disappearance rate of indocyanine green depends not only on hepatocyte function but also hepatic blood flow, the disappearance rate of indocyanine green is considered to be affected by the systemic circulation. Although the disappearance rate of indocyanine green is slower in cirrhotic patients, a hyperdynamic state is reported to be present. Purpose of this study was to evaluate hepatic function and systemic circulation simultaneously with reference to the hyperdynamic state of cirrhotic liver.
Forty-six patients were selected randomly for this study. Simultaneous measurement of effective hepatic blood flow and systemic circulation using an indocyanine green clearance meter was performed. We calculated the effective hepatic blood flow using the early disappearance rate of indocyanine green movement, cardiac output, and circulating time simultaneously with indocyanine green clearance meter.
Hepatic function and hyperdynamic circulation could be evaluated quantitatively. The indocyanine green disappearance rate was dependent on cardiac index in normal subjects, whereas the indocyanine green disappearance rate was lower in cirrhotic patients, although the cardiac index was relatively high.
Hepatic function and systemic circulation could be evaluated simultaneously with this indocyanine green clearance meter. Hyperdynamic circulation was suggested to compensate the impaired hepatic function of cirrhotic liver. Simultaneous measurement of hepatic function and systemic circulation may be essential to studying liver function.
背景/目的:由于吲哚菁绿的消失率不仅取决于肝细胞功能,还取决于肝血流量,因此吲哚菁绿的消失率被认为受体循环影响。尽管肝硬化患者吲哚菁绿的消失率较慢,但据报道存在高动力状态。本研究的目的是参照肝硬化肝脏的高动力状态同时评估肝功能和体循环。
本研究随机选取46例患者。使用吲哚菁绿清除仪同时测量有效肝血流量和体循环。我们使用吲哚菁绿清除仪,通过吲哚菁绿移动的早期消失率、心输出量和循环时间来计算有效肝血流量。
肝功能和高动力循环可以进行定量评估。在正常受试者中,吲哚菁绿消失率取决于心脏指数,而在肝硬化患者中,尽管心脏指数相对较高,但吲哚菁绿消失率较低。
使用这种吲哚菁绿清除仪可以同时评估肝功能和体循环。提示高动力循环可代偿肝硬化肝脏受损的肝功能。同时测量肝功能和体循环对于研究肝功能可能至关重要。