Dutta Hemonta Kr, Rao D N, Gupta D K
Department of Pediatric Surgery, Assam Medical College, Dibrugarh, Assam, India.
Department of Biochemistry, AIIMS, New Delhi, India.
Afr J Paediatr Surg. 2018 Jan-Mar;15(1):5-9. doi: 10.4103/ajps.AJPS_78_16.
Indocyanine green clearance test (ICG-K) has been shown as a sensitive marker of liver function in patients with cirrhosis. However, its role in the assessment of liver function in children with biliary atresia is not well established. The present study was undertaken to evaluate the ICG-K in an experimental model of cholangitis and partial biliary obstruction.
Thirty albino rats were divided into 3 groups of 10 each. After exploration under anesthesia, a vial of OK-432 diluted in 0.2 ml of normal saline was injected into the common bile duct (CBD) in rats of Groups B and C. In the control Group A, only saline was injected. Re-exploration was done at 3 weeks in Groups A and B and at 6 weeks in Group C, and freshly prepared ICG was injected into the inferior vena cava. Blood samples were collected at periodic intervals, optical density of the serum was measured, and half-life of ICG and fractional clearance (K) were calculated. Blood and tissue samples were obtained for biochemical tests and histological examination.
The histological changes in CBD and liver were maximum in Group B; this correlated well with the K-value in this group, which was significantly delayed. In Group C, clearance was delayed than the control group with histological changes ranged from mild to moderate inflammation. The control group had normal histology of liver and CBD, and only four rats showed mild portal inflammation.
ICG clearance rate is a reliable marker of liver function and can be utilized for evaluation of liver function in postoperative extrahepatic biliary atresia patients.
吲哚菁绿清除试验（ICG-K）已被证明是肝硬化患者肝功能的敏感标志物。然而，其在评估胆道闭锁患儿肝功能中的作用尚未明确。本研究旨在评估吲哚菁绿清除试验在胆管炎和部分胆管梗阻实验模型中的作用。
30只白化病大鼠分为3组，每组10只。麻醉下探查后，向B组和C组大鼠的胆总管（CBD）注射1小瓶用0.2 ml生理盐水稀释的溶链菌制剂OK-432。A组为对照组，仅注射生理盐水。A组和B组在3周时再次探查，C组在6周时再次探查，并将新配制的吲哚菁绿注入下腔静脉。定期采集血样，测量血清光密度，计算吲哚菁绿的半衰期和分数清除率（K）。采集血液和组织样本进行生化检测和组织学检查。
B组胆总管和肝脏的组织学变化最大；这与该组的K值密切相关，K值明显延迟。C组清除率较对照组延迟，组织学变化为轻度至中度炎症。对照组肝脏和胆总管组织学正常，仅4只大鼠出现轻度门静脉炎症。
吲哚菁绿清除率是肝功能的可靠标志物，可用于评估肝外胆道闭锁术后患者的肝功能。
