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肝硬化患者的吲哚菁绿清除试验及终末期肝病模型评分

Indocyanine green clearance test and model for end-stage liver disease score of patients with liver cirrhosis.

作者信息

Sheng Qin-Song, Lang Ren, He Qiang, Yang Yong-Jiu, Zhao De-Fang, Chen Da-Zhi

机构信息

Department of Hepatobiliary and Pancreatosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):46-9.

Abstract

BACKGROUND

The indocyanine green (ICG) clearance test (clearance rate (K) and retention rate at 15 minutes (R15)) is a sensitive indicator to evaluate liver function. The model for end-stage liver disease (MELD) score has emerged as a useful tool for estimating the mortality of patients awaiting liver transplantation and has recently been validated on patients with liver diseases of various etiologies and severity. In this study, we investigated the correlation between the ICG clearance test and MELD score of patients with liver cirrhosis.

METHODS

From June 2007 to March 2008, 52 patients with liver cirrhosis admitted to our center were classified into Child-Pugh class A (8 patients), B (14) and C (30). The ICG clearance test (K value and R15) was performed by ICG pulse spectrophotometry (DDG-3300K), and the MELD scores of patients were calculated.

RESULTS

As the Child-Pugh classification of liver function gradually deteriorated, the K value decreased, while R15 and MELD score increased. There were significant statistical differences in K value, R15 and MELD score in patients with different Child-Pugh classifications. Significant correlations were found between the parameters of the ICG clearance test (K value and R15) and MELD score. A negative correlation was observed between K value and MELD score (r=-0.892, P<0.05), while a positive correlation was observed between R15 and MELD score (r=0.804, P<0.05).

CONCLUSIONS

The ICG clearance test and MELD score are good parameters for evaluating liver function. Moreover, K value and R15 have significant correlations with MELD score, especially the K value, which may be a convenient and appropriate indicator to evaluate liver function of patients with liver cirrhosis.

摘要

背景

吲哚菁绿(ICG)清除试验(清除率(K)和15分钟潴留率(R15))是评估肝功能的敏感指标。终末期肝病模型(MELD)评分已成为估计等待肝移植患者死亡率的有用工具,最近已在各种病因和严重程度的肝病患者中得到验证。在本研究中,我们调查了肝硬化患者ICG清除试验与MELD评分之间的相关性。

方法

2007年6月至2008年3月,入住本中心的52例肝硬化患者分为Child-Pugh A级(8例)、B级(14例)和C级(30例)。采用ICG脉冲分光光度法(DDG-3300K)进行ICG清除试验(K值和R15),并计算患者的MELD评分。

结果

随着肝功能Child-Pugh分级逐渐恶化,K值降低,而R15和MELD评分升高。不同Child-Pugh分级患者的K值、R15和MELD评分存在显著统计学差异。ICG清除试验参数(K值和R15)与MELD评分之间存在显著相关性。K值与MELD评分呈负相关(r=-0.892,P<0.05),而R15与MELD评分呈正相关(r=0.804,P<0.05)。

结论

ICG清除试验和MELD评分是评估肝功能的良好参数。此外,K值和R15与MELD评分具有显著相关性,尤其是K值,可能是评估肝硬化患者肝功能的方便且合适的指标。

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