吲哚氰绿试验联合CTP分级对肝硬化患者肝储备功能评估的研究  

Research of cirrhosis of the liver in patients with hepatic functional reserve assessment by ICG test combine with CTP classification

作　　者：张锦峰[1] 梁瑞敏[2] 仪文静[1] 郭佳[1] 郭静[1] 高景华[1] 

机构地区：[1]山西省中医药研究院,山西太原030012 [2]山西省中医院,山西太原030012

出　　处：《中医临床研究》2013年第9期99-101,共3页Clinical Journal Of Chinese Medicine

基　　金：吴阶平医学基金会肝病医学部肝功能评价方法研究;课题编号:LDWMF-PJ-2011B003

摘　　要：探寻吲哚氰绿(ICG)试验与CTP分级两者之间在评价肝脏储备功能方面的相关性,尝试提出与肝硬化诊断相关的指标数据并建立数学模型。方法:利用脉冲式色素浓度图像分析仪(DDG)分别对30例健康志愿者及196例肝硬化患者行ICG排泄试验,测定ICG血浆清除率(K)、15min滞留率(R15)和肝脏有效血流量(EHBF);并测定血常规、肝功能、肾功能、凝血、腹部B超或CT、MRI检查,两名主治医师进行CTP评分分级。比较肝硬化患者的K、R15、EHBF与CTP分级及分值之间的关系,分析得出与肝硬化诊断相关度最高的指标数据并建模。结果:正常人K:(0.227±0.046)/min、R15:(4.10±2.48)%、EHBF:(1.353±0.461)L/min;与CTP分级属A级的肝硬化患者相比较,均有统计学意义(P<0.05)。随着CTP分值的升高,ICG试验指标中K、EHBF逐步降低,R15逐渐升高;B级、C级与A级比较,各指标之间均有显著差异(P<0.05),C级与B级比较,R15有统计学意义(P<0.05)。通过统计分析得出回归方程为:P=1{1+e-(5.043-0.729RBC+2.057EHBF-33.558K)},该数学模型对肝硬化诊断的准确度为75.5%。结论:ICG试验联合CTP分级可以较为准确的评估肝硬化患者的病情,建立的数学模型对肝硬化的诊断有一定意义,其价值有待进一步研究。Objectives： To investigate the correlation between ICG test and CTP classification to evaluate liver reserve function. And then try to provide index data related to cirrhosis diagnosis and set up mathematical molding. Methods： 30 healthy volunteers and 196 cirrhosis patients are elected to join ICG test and determine ICG plasma clearance, 15min retention rate and effective hepatic blood flow by DDG. Moreover, blood routine, liver function, renal function, coagulation, B-type ultrasonic or CT and MRI are to be inspected. All the patients are to be classified by 2 doctors. The relationship between K value, 15rain retention rate, EHBF of cirrhosis and CTP classification should be analyzed, then provide some factors closely related to cirrhosis diagnosis, set up moldings accordingly. Results： It＇s significant to compare cirrhosis belongs to A grade of CTP classification with K： （0.227 ± 0.046）/rain, R15：（4.10±2.48）%, EHBF： （1.353±0.461） L/min of healthy volunteers. With the rise of CTP, K value and EHBF in ICG test are lower gradually, and R15 is higher. What＇s more, there＇s significant difference between B grade and C grade among every index compared with A. Whereas, R15 has statistic significant compared with B and C. Regression equation can be obtained by statistical analysis thatP=1/{1＋e-（5.043-0.729RBC＋2.05EHBF-33.558K）}. The accuracy of this mathematical molding can reach to 75.5% to cirrhosis diagnosis. Conclusion： ICG test and CTP classification can estimate cirrhosis patient＇s condition accurately. There＇s significance to cirrhosis diagnosis to build up mathematical moldings and its value remains to be further research.

关 键 词：肝硬化 吲哚氰绿试验 CTP分级 肝储备功能 

分 类 号：R657.31[医药卫生—外科学]