Tarantino Giovanni
World J Gastroenterol. 2009 Jul 28;15(28):3457-61. doi: 10.3748/wjg.15.3457.
It has been emphasized that the assessment of residual liver function is of paramount importance to determine the following: severity of acute or chronic liver diseases independent of etiology; long-term prognosis; step-by-step disease progression; surgical risk; and efficacy of antiviral treatment. The most frequently used tools are the galactose elimination capacity to asses hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, and antipyrine clearance to estimate microsomal activity. However, a widely accepted liver test (not necessarily a laboratory one) to assess quantitative functional hepatic reserve still needs to be established, although there have been various proposals. Furthermore, who are the operators that should order these tests? Advances in analytic methods are expected to allow quantitative liver function tests to be used in clinical practice.
需要强调的是,评估残余肝功能对于确定以下方面至关重要:独立于病因的急慢性肝病的严重程度;长期预后;疾病的逐步进展;手术风险;以及抗病毒治疗的疗效。最常用的工具包括用于评估肝细胞胞浆活性的半乳糖清除能力、用于评估排泄功能的吲哚菁绿血浆清除率以及用于估计微粒体活性的安替比林清除率。然而,尽管已经有各种提议,但仍需要建立一种广泛接受的肝脏检测方法(不一定是实验室检测方法)来评估肝脏功能储备的定量情况。此外,应该由谁来开具这些检测项目呢?预计分析方法的进步将使定量肝功能检测能够应用于临床实践。