Center of Functional and Diagnostic Imaging and Research, Department of Clinical Physiology and Nuclear Medicine 260, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Department of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark.
J Gastroenterol Hepatol. 2022 Apr;37(4):692-699. doi: 10.1111/jgh.15778. Epub 2022 Feb 2.
The study was undertaken in order to compare single injection indocyanine green (ICG)-clearances with the steady-state ICG-clearance (ICG ) in patients with cirrhosis in order to assess the most accurate estimate for ICG-clearance and to relate the ICG-clearances to established indicators of liver dysfunction.
Thirty-eight patients (male 29) with cirrhosis (Child-Turcotte class A 8, class B 21, and class C 9) were studied during a hemodynamic investigation. A single injection of ICG was followed by blood samples for 5, 10, 15, and 20 min. The dose/plasma area clearance (Cl ) and plasma volume · initial slope clearance (Cl ) were determined and compared with the steady-state infusion/plasma concentration ratio clearance (ICG ).
The Cl (310; 214; 502 mL/min) and Cl (294; 164; 481 mL/min) correlated closely with ICG (243; 120; 383 mL/min [median; interquartile range], R = 0.95-0.98, P < 0.000), but were significantly higher than ICG (P < 0.001). All three clearance measures correlated significantly with biochemical and hemodynamic variables of liver dysfunction (P < 0.05-0.000). All three ICG-clearances showed significantly lower values in patients with ascites compared to those without, and lower ICG-clearance values were present in patients with esophageal varices compared to those without (P < 0.05-0.002).
Single injection markers (Cl and Cl ) of the steady-state ICG-clearance as derived from the ICG-retention curve and the plasma volume correlate with ICG and established variables of portal hypertension and liver cell bile excretory dysfunction. Therefore, these markers can safely replace the more costly ICG .
本研究旨在比较肝硬化患者单次注射吲哚菁绿（ICG）清除率与稳态 ICG 清除率（ICG），以评估 ICG 清除率的最准确估计值，并将 ICG 清除率与已建立的肝功能障碍指标相关联。
38 例肝硬化患者（男 29 例）在血流动力学研究期间接受了检查。单次注射 ICG 后，采集 5、10、15 和 20 分钟的血样。测定剂量/血浆面积清除率（Cl）和血浆体积·初始斜率清除率（Cl），并与稳态输注/血浆浓度比清除率（ICG）进行比较。
Cl（310；214；502 mL/min）和 Cl（294；164；481 mL/min）与 ICG（243；120；383 mL/min[中位数；四分位间距]，R=0.95-0.98，P<0.000）密切相关，但明显高于 ICG（P<0.001）。所有三种清除率均与肝功能障碍的生化和血流动力学变量显著相关（P<0.05-0.000）。与无腹水患者相比，所有三种 ICG 清除率在腹水患者中均显著降低，与无食管静脉曲张患者相比，食管静脉曲张患者的 ICG 清除率也较低（P<0.05-0.002）。
从 ICG 保留曲线和血浆体积推导的稳态 ICG 清除率的单次注射标志物（Cl 和 Cl）与 ICG 和门静脉高压及肝细胞胆汁排泄功能障碍的已建立变量相关。因此，这些标志物可以安全替代更昂贵的 ICG。
