Kubota A, Okada A, Fukui Y, Kawahara H, Imura K, Kamata S
Department of Pediatric Surgery, Osaka University Medical School, Japan.
J Pediatr Gastroenterol Nutr. 1993 Jan;16(1):61-5. doi: 10.1097/00005176-199301000-00012.
In order to evaluate liver function in postoperative biliary atresia (BA) patients, the indocyanine green (ICG) clearance test was performed. Nineteen patients, ranging in age from 2 to 9 years, were classified into three groups. Group I were those who had no jaundice throughout the postoperative period (n = 9), Group II were those who had recurrent or intermittent jaundice (n = 7), and Group III were those who had persistent jaundice after hepatic portojejunostomy (n = 3). Forty-four volunteers of comparative age and sex served as controls to establish a normal range of ICG-K values in infants and children. The normal minimal ICG-K value in those 2-9 years of age was defined as 0.19. ICG-K values in BA patients were 0.262 +/- 0.073 (Group I), 0.150 +/- 0.060 (Group II), and 0.054 +/- 0.011 (Group III). All nine patients with ICG-K below the normal level had esophageal varices, and seven of nine had a history of gastrointestinal hemorrhage. Two patients with ICG-K values within the normal range had esophageal varices, and none had a history of gastrointestinal hemorrhage. Five of nine patients with ICG-K values below normal had low serum albumin levels, and all had low prealbumin levels. Of those with ICG-K within the normal range, none had low serum albumin or prealbumin levels. On the other hand, serum bilirubin and other liver function tests did not accurately reflect clinical findings. In conclusion, the ICG test using the ICG-K value was confirmed to be a reliable indicator of postoperative liver function in BA patients.
为了评估术后胆道闭锁（BA）患者的肝功能，进行了吲哚菁绿（ICG）清除试验。19例年龄在2至9岁之间的患者被分为三组。第一组是术后整个期间无黄疸的患者（n = 9），第二组是有反复或间歇性黄疸的患者（n = 7），第三组是肝门空肠吻合术后仍有持续性黄疸的患者（n = 3）。44名年龄和性别匹配的志愿者作为对照，以确定婴幼儿和儿童ICG-K值的正常范围。2至9岁人群的正常最低ICG-K值定义为0.19。BA患者的ICG-K值分别为0.262±0.073（第一组）、0.150±0.060（第二组）和0.054±0.011（第三组）。所有9例ICG-K值低于正常水平的患者均有食管静脉曲张，其中9例中有7例有胃肠道出血史。2例ICG-K值在正常范围内的患者有食管静脉曲张，但均无胃肠道出血史。9例ICG-K值低于正常的患者中有5例血清白蛋白水平低，且所有患者前白蛋白水平均低。ICG-K值在正常范围内的患者中，无血清白蛋白或前白蛋白水平低的情况。另一方面，血清胆红素和其他肝功能检查不能准确反映临床情况。总之，使用ICG-K值的ICG试验被证实是BA患者术后肝功能的可靠指标。
