Koruk Mehmet, Ozkiliç Sinasi, Savas M Cemil, Celen Zeki, Kadayifçi Abdurrahman, Ozkiliç Canan
Department of Internal Medicine, University of Gaziantep, Gaziantep, Turkey.
Hepatogastroenterology. 2003 Nov-Dec;50(54):1803-5.
BACKGROUND/AIMS: Aim of the study is to determine the changes in hepatocyte and gallbladder motor functions, and biliary dynamics in patients with liver cirrhosis.
The study group consisted of 17 patients with liver cirrhosis (12 males, 5 females) who were diagnosed by clinical, laboratory and histopathologic findings. Control group consisted of 20 healthy persons (14 males, 6 females). Quantitative hepatobiliary scintigraphy was performed by using Tc99m-Mebrofenin i.v. and dynamic images were obtained and evaluated quantitatively by computer. Maximum excretion time of radiodiagnostic agent by liver (Tmax) and half excretion time of radio-diagnostic agent from liver (T 1/2), gallbladder filling time, gallbladder ejection fraction and the transit time of bile to duodenum were determined.
Mean values of Tmax was 25.76 vs. 12.40 min, T 1/2 was 37.55 vs. 23.15 min, gallbladder filling time was 53.35 vs. 30.57 min, and transit time of bile to duodenum was 39.88 vs. 25.00 min in the patients and control group, respectively. These values increased significantly in the patient group (p < 0.05) compared to controls. Mean gallbladder ejection fraction was 37.55% in the patient group and 41.84% in the control group without any statistical significance (p > 0.05). The incidence of gallbladder stone was 29.41% in the cirrhosis group and 5% in the control group (p < 0.05).
The quantitative hepatobiliary scintigraphy is a simple and reliable method in evaluation of hepatic functions and biliary dynamics in cirrhotic patients. Although the incidence of gallbladder stone is significantly increased in cirrhotic patients, it seems that a stone in the gallbladder does not affect the gallbladder motor functions.
背景/目的：本研究旨在确定肝硬化患者肝细胞和胆囊运动功能以及胆汁动力学的变化。
研究组由17例肝硬化患者（12例男性，5例女性）组成，这些患者通过临床、实验室和组织病理学检查确诊。对照组由20名健康人（14例男性，6例女性）组成。静脉注射锝99m-美布芬宁进行定量肝胆闪烁扫描，获取动态图像并通过计算机进行定量评估。测定肝脏对放射性诊断剂的最大排泄时间（Tmax）、肝脏放射性诊断剂的半排泄时间（T 1/2）、胆囊充盈时间、胆囊排空分数以及胆汁排入十二指肠的转运时间。
患者组和对照组的Tmax平均值分别为25.76分钟和12.40分钟，T 1/2分别为37.55分钟和23.15分钟，胆囊充盈时间分别为53.35分钟和30.57分钟，胆汁排入十二指肠的转运时间分别为39.88分钟和25.00分钟。与对照组相比，患者组这些值显著升高（p < 0.05）。患者组平均胆囊排空分数为37.55%，对照组为41.84%，无统计学意义（p > 0.05）。肝硬化组胆囊结石发生率为29.4%，对照组为5%（p < 0.05）。
定量肝胆闪烁扫描是评估肝硬化患者肝功能和胆汁动力学的一种简单可靠的方法。虽然肝硬化患者胆囊结石的发生率显著增加，但胆囊结石似乎并不影响胆囊运动功能。
