Cieslak Kasia P, Baur Onno, Verheij Joanne, Bennink Roelof J, van Gulik Thomas M
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
HPB (Oxford). 2016 Aug;18(8):691-6. doi: 10.1016/j.hpb.2016.05.011. Epub 2016 Jun 20.
Age itself is not considered a contraindication for high impact surgery. However, the aging process of the liver remains largely unknown. This study evaluates age-dependent changes in liver function using a quantitative liver function test.
Between January 2005 and December 2014, 508 patients underwent (99m)Tc-mebrofenin hepatobiliary scintigraphy (HBS) for the assessment of liver function. These included 203 patients with healthy livers (group A) and 57 patients with HCC and Child-Pugh A (group B). (99m)Tc-mebrofenin-uptake-rate of the whole liver corrected for body surface area (cMUR) was calculated for all patients. Linear regression analysis was performed to assess the relationship between age and cMUR.
The mean cMUR was 8.50 ± 2.05%/min/m(2) and 6.94 ± 2.03%/min/m(2) in group A and B, respectively. A negative linear correlation was found between patient's age and cMUR in group A, r = 0.244, p = 0.000. In group B, there was no correlation between age and cMUR, however, a trend in decline of liver function with age was noted.
This study shows that liver function deteriorates with age. Since the regenerative capacity of the liver correlates with liver function, this finding should be taken into account when assessing surgical risk in patients considered for major liver resection.
年龄本身并不被视为高冲击手术的禁忌症。然而,肝脏的衰老过程在很大程度上仍然未知。本研究使用定量肝功能测试评估肝功能随年龄的变化。
2005年1月至2014年12月期间,508例患者接受了(99m)锝-美罗芬宁肝胆闪烁显像(HBS)以评估肝功能。其中包括203例肝脏健康的患者(A组)和57例肝癌且Child-Pugh A级的患者(B组)。计算所有患者经体表面积校正的全肝(99m)锝-美罗芬宁摄取率(cMUR)。进行线性回归分析以评估年龄与cMUR之间的关系。
A组和B组的平均cMUR分别为8.50±2.05%/min/m²和6.94±2.03%/min/m²。A组患者年龄与cMUR之间存在负线性相关,r = 0.244,p = 0.000。在B组中,年龄与cMUR之间无相关性,然而,注意到肝功能随年龄有下降趋势。
本研究表明肝功能随年龄而恶化。由于肝脏的再生能力与肝功能相关,在评估考虑进行大肝切除术患者的手术风险时应考虑这一发现。