Shimizu S, Kamiike W, Hatanaka N, Yoshida Y, Tagawa K, Miyata M, Matsuda H
First Department of Surgery, Osaka University Medical School, Suita, Japan.
World J Surg. 1995 Jan-Feb;19(1):113-8; discussion 118. doi: 10.1007/BF00316992.
The maximal removal rate of indocyanine green (ICG Rmax) is considered to be an important parameter of hepatic function. However, the method of analysis has some flaws, and an abnormal value is obtained for about 15% of patients. We developed a new method of measuring the ICG Rmax with a clearance meter (RK-1000) that continuously measured the ICG concentration using a fingertip optical sensor. Twenty patients were examined. The histologic diagnosis was as follows: normal for 10, cirrhosis in 6, hepatitis in 4. The ICG concentration was measured in vivo continuously with the RK-1000. To obtain the Rmax by the Michaelis-Menten model, the ICG concentration in the VLDL compartment was subtracted from the values obtained by the RK-1000 because ICG binds to various serum proteins and its rate of removal in the VLDL compartment differs from that in other protein compartments. The removal velocity was calculated and a Michaelis plot obtained. Then Rmax was calculated from the reciprocal of the y-intercept of a Lineweaver-Burk plot. The Rmax in subjects with liver disease was significantly lower than in those with normal liver. It is concluded that our new method of measuring ICG Rmax with the RK-1000 reflects liver function appropriately.
吲哚菁绿最大清除率（ICG Rmax）被认为是肝功能的一个重要参数。然而，分析方法存在一些缺陷，约15%的患者会得出异常值。我们开发了一种使用清除率仪（RK - 1000）测量ICG Rmax的新方法，该仪器通过指尖光学传感器连续测量ICG浓度。对20名患者进行了检查。组织学诊断如下：正常10例，肝硬化6例，肝炎4例。使用RK - 1000对ICG浓度进行体内连续测量。为通过米氏模型获得Rmax，由于ICG与各种血清蛋白结合，且其在极低密度脂蛋白（VLDL）区室的清除速率与其他蛋白区室不同，因此从RK - 1000获得的值中减去VLDL区室中的ICG浓度。计算清除速度并获得米氏图。然后从Lineweaver - Burk图的y轴截距的倒数计算Rmax。肝病患者的Rmax明显低于正常肝脏患者。结论是，我们使用RK - 1000测量ICG Rmax的新方法能适当地反映肝功能。
