放射核素定量检查评价肝硬化患者的肝脏贮备功能  

Quantitative Assessment of Liver Function with Radionuclioted Scintigraphy in Patients with Hepatic Cirrhosis

作　　者：杨玉珍[1,2,3] 王思元[1,2,3] 梁扩寰[1,2,3] 周健[1,2,3] 吴华[1,2,3] 

机构地区：[1]同济医科大学同济医院消化内科 [2]同济医科大学附属同济医院消化内科 [3]同济医科大学附属同济医院核医学科

出　　处：《胃肠病学和肝病学杂志》1997年第1期66-69,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的：本文对３６例肝硬化患者采用９９ｍＴＣＥＨＩＤＡ（二乙基丁酰苯胺基亚氨二醋酸）进行肝脏动态显像检查，并作定量分析，以便对肝硬化患者的贮备功能作出正确估价。方法：每位患者在检查前禁食４小时以上，检查时仰卧于ｒ相同探头下，静注８８ｍＴＣＥＨＩＤＡＦ４０ＭＢｇ，前位连续功态采集每一帧／６０秒，连续采集３０分钟，６０分钟再作静态采集一帧，经计算机处理手作定量分析。结果：结果表明肝硬化者血液中清除指数（Ｈ５／Ｈ２ｍｉｎ）、心肝比值（Ｈ５／Ｌ５ｍｉｎ）均较对照组明显增大，而３０分钟排泄率则较对照组为低（ＥＸ３０ｍｉｎ）、两组核素显像定量值相比均有显著差异（Ｐ＜０．０１），且与肝硬心病情程度相关，按ｃｈｉｌｄＰｎｇｈ分期，Ａ、Ｂ、Ｃ级之间Ｈ５／Ｈ２ｍｉｎ、Ｈ５／Ｌ５ｍｉｎ、Ｅ×３０ｍｉｎ核素定量结果互相对比均有显著差异（Ｐ＜０．０５～０．０１）。上述三项参数与肝功能实验检测指标间有一定相关性。结论：本组资料提示该方法较敏感反映肝硬化不同时期的贮备功能，对肝硬化的早期诊断等有一定的临床价值。Aims:A quantitative scintigraphic study was performed on 36 patients with cirrhosis and 25 controls.Methods:The patients were devided into three subgroups based on their Child-Pugh class,which were Child-Pugh A,B and C. A dynamic heptic scintigraphy with 99m Tc-EHIDA was carried out in all subjects.Quantitative parameters included blood clearence index(H 5/H 2 min),the ratio of Heart/Liver(H 5/L 5min)and excretion percentage at 30 min (EX 30min ). Results:The results showed that the patients had significant increase of H 5/H 2 min,H 5/L 5 min and decrease of ex 30min (P<0.01.Furthermore,all these indexes showed significant differences among the three subgroups(P<0.05-0.01).In addition,These quantitative parameters correlated with some biochemical indexes of Liver function tests.Comclusions:Thus it is suggested that dynamic hepatic scintigraphy may sensitively reflect the functional damage in patients with cirrhosis at different stages.The method may be helpful for early diagnosis of hepatic cirrhosis.

关 键 词：肝储备功能 肝硬变 放射核素 定量检查 

分 类 号：R575.2[医药卫生—消化系统]