吲哚菁绿试验对HBV相关肝脏疾病的肝脏储备功能及预后评估价值

肝脏 ›› 2016, Vol. 21 ›› Issue (11): 908-910.

吲哚菁绿试验对HBV相关肝脏疾病的肝脏储备功能及预后评估价值

赖瑞敏, 吴银莲, 董菁, 朱月永

350005 福州福建医科大学附属第一医院肝病中心

收稿日期:2016-06-08 出版日期:2016-11-30 发布日期:2020-06-12
通讯作者: 朱月永,Email:ezhu066@sina.cn

Indocyanine green test in evaluating liver reserve function and its prognostic value in patients with HBV-related liver diseases

LAI Rui-min, WU Yin-lian, DONG Jing, ZHU Yue-yong

Liver Diseases Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China

Received:2016-06-08 Online:2016-11-30 Published:2020-06-12
Contact: ZHU Yue-yong, Email: ezhu066@sina.cn

摘要/Abstract

摘要： 目的通过吲哚菁绿清除试验评估HBV相关肝病患者肝脏储备功能,比较吲哚菁绿试验15分钟滞留率(indocyanine green retention rate at 15 minutes,ICG R15)与Child-Turcotte-Pugh score(CTP)分级和终末期肝病模型评分(the model for end-stage liver disease,MELD)对乙型肝炎肝硬化患者预后的评估能力。方法选取56例慢性乙型肝炎(chronic hepatitis B,CHB)和144例乙型肝炎肝硬化患者进行ICG R15检测,采用t检验比较CHB与乙型肝炎肝硬化两者ICG R15的差别,用Spearman相关性分析乙型肝炎肝硬化患者ICG R15与MELD评分及CTP分级的关系;通过受试者工作特征(ROC)曲线法分析ICG R15与MELD评分对肝硬化预后的评估能力。结果 56例CHB患者ICG R15为1.40~9.50,平均值为4.43±2.19;144例乙型肝炎肝硬化患者ICG R15为2.40~60.00,平均值为22.80±16.00,显著高于CHB组,差异有统计学意义(P<0.01)。CTP分级:A级患者70例,MELD评分4.99±2.76;B级患者54例,MELD评分6.24±4.69;C级患者20例,MELD评分11.71±3.77。在评价肝功能方面ICG R15与MELD评分及CTP分级呈正相关(r=0.414、r=0.67,P<0.01)。ICG R15评估乙型肝炎肝硬化患者预后的曲线下面积(AUC)为0.903,最佳截点为9.55%,敏感度为71.5%,特异度为100%。MELD评分AUC为0.634,最佳截点为7.00,敏感度为36.8%,特异度89.3%。结论吲哚菁绿试验能动态反映肝脏储备功能,与MELD评分结合能更好地反映肝脏功能及评估患者预后。

关键词: 慢性乙型肝炎, 肝硬化, 吲哚菁绿清除试验

Abstract: Objective To investigate the accessing value of indocyanine green clearance test for liver functional reserve in patients with hepatitis B virus (HBV)-related liver diseases and its clinical significance. Methods Assessment of indocyanine green retention rate at 15 minutes (ICG R15) was carried out in 56 patients with chronic hepatitis B (CHB) and 144 patients with HBV-related cirrhosis, which were compared by t-test. In addition, the spearman correlation test was used to analyze the relationship among ICGR15, model for end-stage liver disease score (MELD) and Child-Turcotte-Pugh (CTP) class in cirrhosis patients. Finally, the area under the receiver operating characteristic (ROC) curve of ICG R15 and MELD score were calculated to compare their performance in assessing liver functional reserve. Results A total of 200 patients were enrolled, including 127 males and 73 females with mean age of 43±8.1 years. ICG R15 of 144 cirrhosis patients was 2.40%~60.00% with average value of 22.80±16.00, which was significantly higher than 1.40%~9.50% with average value of 4.43±2.19 in CHB patients. Among these patients, there were 70 in class A with MELD score of 4.99±2.76, 56 in class B with MELD score of 6.24±4.69 and 20 in class C with MELD score of 11.71±3.77. In terms of liver reserve function, ICG R15 showed positive correlation with MELD score and CTP class (r=0.414, r=0.67, P<0.01). AUC for ICG R15 and MELD were 0.903 and 0.634 in assessing prognosis of cirrhosis patients, respectively. Conclusion Indocyanine green clearance test could dynamically assess liver functional reserve, and its combination with MELD score could better reflect liver function and assess prognosis.

Key words: Chronic hepatitis B, Liver cirrhosis, Indocyanine green clearance test

赖瑞敏, 吴银莲, 董菁, 朱月永. 吲哚菁绿试验对HBV相关肝脏疾病的肝脏储备功能及预后评估价值[J]. 肝脏, 2016, 21(11): 908-910.

LAI Rui-min, WU Yin-lian, DONG Jing, ZHU Yue-yong. Indocyanine green test in evaluating liver reserve function and its prognostic value in patients with HBV-related liver diseases[J]. Chinese Hepatolgy, 2016, 21(11): 908-910.

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