靛氰绿最大清除率评价肝脏功能指标的临床价值  

Clinical Value of ICGRmax on Appraise Liver Function

作　　者：杨闯[1] 韩礼欧[2] 孙禹南[1] 郑宇[1] 

机构地区：[1]哈尔滨市第一医院普外科,黑龙江哈尔滨150010 [2]哈尔滨医科大学第一临床医学院普外科,黑龙江哈尔滨150001

出　　处：《黑龙江医学》2004年第6期416-418,共3页Heilongjiang Medical Journal

摘　　要：目的　探讨靛氰绿最大清除率 (ICGRmax)判定肝脏功能指标的临床价值。方法　采用分光光度计 ,分别测定 1 0例正常人、30例肝硬化患者、2 0例急性肝炎患者及 30例肝病术前患者的血浆ICG浓度 (负荷量分别为 0 5mg/kg、5mg/kg) ,计算出靛氰绿血浆消失率 (KICG) ,再按Michaelis -Menten公式计算出IC GRmax ,并进行比较。结果　正常人ICGRmax :3 71mg/ (kg·min)± 1 4mg/ (kg·min) ;KICG :0 1 87± 0 0 1 9。肝硬化组代偿期KICG 0 1 88± 0 0 4 0和ICGRmax(0 878± 0 2 6 9)mg/ (kg·min)均明显高于失代偿期KICG(0 0 79± 0 0 33)和ICGRmax(0 396± 0 2 0 8)mg/ (kg·min) (P <0 0 5 )。代偿期KICG(0 1 88± 0 0 4 )与KICG正常值(0 1 87± 0 0 1 9)相比无显著差异 (P =0 92 0 0 ) ,但代偿期ICGRmax(0 878± 0 2 6 9)mg/ (kg·min)却明显低于ICGRmax正常值 (3 71± 1 4 )mg/ (kg·min) (P <0 0 0 0 1 )。急性肝炎组 :急性期KICG(0 0 96± 0 0 32 )mg/ (kg·min)与恢复期KICG (0 1 0 8± 0 0 4 6 )mg/ (kg·min)无明显差异 (P =0 30 1 5 ) ,但急性期ICGRmax(1 0 1 0±0 5 95 )mg/ (kg·min)与恢复期ICGRmax(3 1 5 5± 1 797)mg/ (kg·min)有明显差异 (P <0 0 5 )。手术组Objective To investigate the clinical value of Indocyanine Green Removal maximum (ICGRmax) and its role as a clinical marker of liver function. Methods The level of ICG (0.5 mg/kg and 5 mg/kg) was measured by spectrophoto meter in 10 controls and in 30 cases with liver cirrhosis. In 20 cases with acute hepatitis and in 30 cases who need to be operated with abnormal liver function of different degree. According to the formula of Michalis-Menter, the results of ICGRmax will be calculated. Results (1) control group: ICGRmax 3.71±1.4 mg/kg/min KICG 0.187± 0.019 (2) Liver cirrhosis group: KICG (0.188±0.040) and ICGRmax (0.878±0.269) in comp stage was significantly higher than KICG (0.079±0.033) and ICGRmax (0.396±0.208) of decomp stage (P<0.05). There was noinicalValueofICGRsignificantdifferenceofKICG (0 .1 88± 0 .0 4 0 )incompandcontrols (0 .1 87± 0 .0 1 9) (P =0 .92 0 0 ) .ButICGRmax (0 .878± 0 .2 6 9)incompwassignificantlylowerthanthatofcontrols (3.1 7± 1 .4 ) (P <0 .0 0 1 ) .(3) (acutehepati tisgroup :therewasnosignificantdifferenceofKICG (0 .0 96± 0 .0 32 )andconvalescentstage (0 .1 0 8± 0 .0 4 6 ) .But ICGRmaxinacutestage (0 .0 1 0± 0 .5 95 )andconvalescentstageICGRmax (3.1 5 5± 1 .797)wassignificantdifference (P <0 .0 5 ) (4 )operationgroupThelevelofICGRmaxwasnegativelycorrelatedwiththeresultofoperation (r =0 . 75 341 ,P =0 .0 0 31 ) .Conclusion KICGandICGRmaxweresensitiveinabnormalliverfunction .ButICGRmaxwas moresensitiveindefectionofabnormalliverfunction ,whichcouldreflectthechangeofthetotalfunctioninghepaticcell massandjudgesensitivityandreliabilityonevaluationofliverfunction .SoICGRmaxwassignificantvalueasaclinical markerofevaluationofliverfunction .

关 键 词：普通外科学 肝脏功能 靛氰绿血浆消失率 靛氰绿最大消除率 

分 类 号：R657.34[医药卫生—外科学]