Noguera E C, Wafa Hames A, Noguera E C
Gastroenterología, Hepatología, Hospital de Nuestra Sra. de la Misericordia, Córdoba.
Medicina (B Aires). 1995;55(5 Pt 1):385-90.
Quantitative hepatobiliary scintigraphy (Q.H.S.), with 99m Tc-DISIDA was performed on 15 control subjects and 32 alcoholic cirrhotic patients (A.C.). We used a dynamic planar scintigraphy (30 seg/frame, up to 45 min) technique following injection intravenously of 99m Tc-DISIDA. Time/activity curves were obtained from the right upper lobe of the liver and the: 1) slope uptake, 2) half-time (T 1/2 min) uptake, 3) excretion half-time (T1/2 min), were measured from the curve. The A.C. were divided in two groups, IIA (n = 32) and IIB (n = 6) if the excretory curve show negative slope or not respectively.
The mean value (+/- 1 D.S. 95% coinfidence interval) of the slope uptake of the A.C. IIB (1.2 +/- 0.40) was significantly slower than a.C. IIA (2.8 +/- 0.39) and control (4.5 +/- 1.17, p = 0.0001 respectively). The difference also was significantly when the mean of A.C. IIA was compared to control (p = 0.007). The mean of T1/2 uptake of A.C.IIB (62.2 +/- 22.2) was significantly longer than A.C. IIA (28.4 +/- 4.4 p = 0.011) and control (17.9 +/- 3.87, p = 0.003). The mean T1/2 excretory of the A.C. IIA (90.0 +/- 17.8) was also significant delayed compared to the mean of normal control (35.6 +/- 7.6 p = 0.001). In the A.C. IIB the excretion plateau curve was associated with visualization of the gallbladder and bowel activity suggesting that the excretion of the IDA preferentially came from the left hepatic lobe. We conclude that alcoholic cirrhotic patients have impaired the mechanism related with the uptake/excretion transport of organic anion, and suggest that noninvasive Q.H.S. with 99m Tc-DISIDA, can be a useful clinical technique to be used for the quantification of hepatic function in cirrhotic alcoholic patients.
对15名对照受试者和32名酒精性肝硬化患者（A.C.）进行了用99m锝-二异丙基乙酰苯胺（99m Tc-DISIDA）的定量肝胆闪烁扫描（Q.H.S.）。在静脉注射99m Tc-DISIDA后，我们采用动态平面闪烁扫描技术（每帧30秒，最长45分钟）。从肝脏右上叶获取时间/活性曲线，并测量：1）摄取斜率，2）摄取半衰期（T 1/2分钟），3）排泄半衰期（T1/2分钟），均从曲线上测量。如果排泄曲线分别显示负斜率或无负斜率，则将A.C.患者分为两组，IIA组（n = 32）和IIB组（n = 6）。
A.C. IIB组摄取斜率的平均值（±1标准差95%置信区间）（1.2±0.40）明显慢于A.C. IIA组（2.8±0.39）和对照组（4.5±1.17，p分别为0.0001）。当将A.C. IIA组的平均值与对照组比较时，差异也很显著（p = 0.007）。A.C.IIB组摄取T1/2的平均值（62.2±22.2）明显长于A.C. IIA组（28.4±4.4，p = 0.011）和对照组（17.9±3.87，p = 0.003）。与正常对照组平均值（35.6±7.6，p = 0.001）相比，A.C. IIA组的平均排泄T1/2也明显延迟。在A.C. IIB组中，排泄平台曲线与胆囊和肠道活动的显影相关，提示IDA的排泄优先来自左肝叶。我们得出结论，酒精性肝硬化患者与有机阴离子摄取/排泄转运相关的机制受损，并表明用99m Tc-DISIDA进行的非侵入性Q.H.S.可成为用于定量酒精性肝硬化患者肝功能的一种有用的临床技术。
