吲哚菁绿清除试验在肝脏缺血再灌注损伤中的临床评价  

Indocyanine green clearance test in clinical evaluation of hepatic ischemia-reperfusion injury

作　　者：武贵林[1,2] 缪雪蓉[1] 陆智杰[1] 邱海波[1] 陶坤明[1] 杨立群[1] 俞卫锋[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院麻醉科,上海200438 [2]解放军第303医院

出　　处：《上海医学》2011年第8期598-600,共3页Shanghai Medical Journal

摘　　要：目的探讨吲哚菁绿(ICG)清除试验评价肝脏缺血再灌注损伤(HIRI)的临床意义。方法收集第二军医大学附属东方肝胆外科医院2010年6月-2010年12月26例原发性肝癌行肝癌切除术的患者,随机分为对照组(行常规手术,14例)和缺血预处理(IPC)组(切肝前对第1肝门实施10 min缺血及10 min再灌注,12例)。比较两组患者的术前,术后第1、3、7天的ICG清除率(ICGK),以及血清总胆红素(TBIL)、总胆汁酸(TBA)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)的水平。结果 IPC组在术后第1、3、7天的血清ALT水平均显著低于对照组(P值均<0.05),IPC组在术后第1天的AST水平显著低于对照组(P<0.05)。两组间术后同一时间点ICGK、TBIL、TBA、ALB的差异均无统计学意义(P值均>0.05)。结论 ICG清除试验作为一种评价肝脏储备功能的指标并不能很好的评价HIRI。Objective To investigate the clinical significance of indocyanine green clearance test in evaluating hepatic ischemia-reperfusion injury（HIRI）.Methods Totally 26 patients with primary hepatocarcinoma who underwent liver resection from Jun.2010 to Dec.2010 in our hospital were included in the present study.The patients were randomly divided into control group（routine operation,n=14） and ischemia preconditioning（IPC） group（hepatic portal eschemia for 10 min followed by 10 min reperfution before liver resectiobn,n=12）.The indocyanine green clearance（ICGK）,total bilirubin（TBIL）,total bile acid（TBA）,albumin（ALB）,alanine amiotransferase（ALT）,and aspartate aminotransferase（AST） in peripheral blood before and on 1,3,and 7 days after surgery were compared between the two groups.Results The ALT levels in the peripheral blood in IPC group were significantly lower than those in the control group on 1,3,and 7 days after surgery（all P0.05）.The AST level was significantly lower in the IPC group than that in the control group on 1 day after operation（all P0.05）.There were no significant differences in the levels of ICGK,TBIL,TBA,and ALB between the two groups at the same time points after operation.Conclusion As an indicator of liver reserve function,ICG clearance test is not suitable for evaluation of liver ischemia-reperfusion injury.

关 键 词：吲哚菁绿清除试验 肝脏缺血再灌注损伤 缺血预处理 丙氨酸氨基转移酶 天冬氨酸氨基转移酶 

分 类 号：R735.7[医药卫生—肿瘤]