Pimstone N R, Stadalnik R C, Vera D R, Hutak D P, Trudeau W L
Department of Internal Medicine, University of California--Davis Medical Center, Sacramento 95817.
Hepatology. 1994 Oct;20(4 Pt 1):917-23. doi: 10.1002/hep.1840200421.
We have developed a quantitative functional imaging study of the liver using a radiolabeled asialoglycoprotein analog, Tc-galactosyl-neoglycoalbumin. Heart and liver time-activity data can be transformed by automated kinetic analysis into asialoglycoprotein hepatocyte receptor concentration. Twenty-eight healthy controls, 46 patients with noncholestatic chronic liver injury and 11 patients with primary biliary cirrhosis were studied. Liver function was also assessed by Pugh modified-Child-Turcotte criteria, 14C-aminopyrine breath test and indocyanine green clearance (24 patients).
(a) In normal controls with a Child-Turcotte criteria score of 5, receptor concentration ranged from 0.63 to 1.19 mumol/L, with a mean 0.83 +/- 2 S.D. 0.06 mumol/L, which was significantly higher (p < 0.001) than that of the patient group (mean receptor concentration = 0.44 +/- 2 S.D. 0.04 mumol/L). In cirrhotic patients with Child-Turcotte criteria score of 5, the mean receptor concentration was 0.60 +/- 2 S.D. 0.07 mumol/L, which was significantly lower than controls (p < 0.01). In end-stage cirrhosis (Child-Turcotte criteria score 11 to 15), a group in which patients died or required orthotopic liver transplantation within 1 yr, the mean receptor concentration was 0.35 +/- 2 S.D. to 0.07 mumol/L. The sensitivity and specificity for receptor concentration in relation to liver disease, with values above 0.65 mumol/L being normal, were 0.96 and 0.88, respectively. Receptor concentration correlated well with Child-Turcotte criteria score (r = 0.78, p = < 0.001), with aminopyrine breath test (r = 0.75, p = < 0.001) and with indocyanine green clearance (r = 0.88, p = < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
我们利用放射性标记的去唾液酸糖蛋白类似物锝-半乳糖基-新糖白蛋白开展了一项肝脏定量功能成像研究。心脏和肝脏的时间-活性数据可通过自动动力学分析转化为去唾液酸糖蛋白肝细胞受体浓度。对28名健康对照者、46名非胆汁淤积性慢性肝损伤患者以及11名原发性胆汁性肝硬化患者进行了研究。还采用Pugh改良Child-Turcotte标准、14C-氨基比林呼气试验和吲哚菁绿清除率（对24名患者）评估了肝功能。
(a) Child-Turcotte标准评分为5分的正常对照者，受体浓度范围为0.63至1.19 μmol/L，平均为0.83±2标准差0.06 μmol/L，显著高于患者组（平均受体浓度 = 0.44±2标准差0.04 μmol/L，p<0.001）。Child-Turcotte标准评分为5分的肝硬化患者，平均受体浓度为0.60±2标准差0.07 μmol/L，显著低于对照者（p<0.01）。在终末期肝硬化（Child-Turcotte标准评分11至15分）中，这组患者在1年内死亡或需要进行原位肝移植，平均受体浓度为0.35±2标准差至0.07 μmol/L。以受体浓度>0.65 μmol/L为正常，其对肝病的敏感性和特异性分别为0.96和0.88。受体浓度与Child-Turcotte标准评分（r = 0.78，p = <0.001）、氨基比林呼气试验（r = 0.75，p = <0.001）以及吲哚菁绿清除率（r = 0.88，p = <0.001）均具有良好的相关性。（摘要截选至250词）
