Moody F G, Rikkers L F, Aldrete J S
Ann Surg. 1974 Oct;180(4):592-8. doi: 10.1097/00000658-197410000-00024.
Functional hepatic reserve was determined in 32 patients with known liver or biliary tract disease employing kinetic analysis of hepatic removal of indocyanine green (ICG). The initial removal rates of incremental doses of ICG (0.5, 1.0 and 5.0 mg/kg body weight) were plotted as a reciprocal against the inverse of dose (Lineweaver-Burk plot) to provide a means of determining maximal removal rate from submaximal doses (Rmax). This function equalled 3.40 mg/kg/min in ten patients with normal livers, but was only .24 mg/kg/min in eight patients with alcoholic cirrhosis. Portasystemic shunting did not further influence Rmax. Infiltrative liver disease had only a mild depressive effect on this function. The results show that hepatic function can be precisely quantitated by classical enzyme kinetics (Michaelis-Menten). If Rmax is an estimate of protein receptor mass for organic anions, then the technique may allow an indirect means for quantitating hepatocytes even in the presence of changes in blood flow or hepatic function. The profound depression in R(max) observed in patients with alcoholic cirrhosis is consistent with the progressive loss in hepatic mass associated with this disease.
采用对吲哚菁绿（ICG）肝脏清除进行动力学分析的方法，对32例已知患有肝脏或胆道疾病的患者测定其功能性肝储备。将递增剂量的ICG（0.5、1.0和5.0mg/kg体重）的初始清除率绘制成与剂量倒数的倒数关系图（Lineweaver-Burk图），以提供一种从次最大剂量确定最大清除率（Rmax）的方法。该功能在10例肝脏正常的患者中为3.40mg/kg/min，但在8例酒精性肝硬化患者中仅为0.24mg/kg/min。门体分流并未进一步影响Rmax。浸润性肝病对该功能仅有轻度抑制作用。结果表明，肝功能可通过经典酶动力学（米氏方程）进行精确量化。如果Rmax是有机阴离子蛋白质受体量的估计值，那么该技术可能提供一种即使在血流或肝功能发生变化时也能间接定量肝细胞的方法。在酒精性肝硬化患者中观察到的Rmax的显著降低与该疾病相关的肝脏质量的逐渐丧失是一致的。
