【Abstract】：Objective To investigate the clinical value of the 13C-methacetin breath test (MBT) for assessing liver function in patients with cirrhosis. Methods One-hundred-thirty-nine patients with liver cirrhosis, 34 hepatitis patients, and 22 healthy controls were studied. Patients with cirrhosis were divided into groups according to Child-Pugh score and model of end-stage liver disease (MELD) score. All study participants underwent 13C-MBT. The three major parameters of 13C-MBT were recorded (maximum excretion rate before 40 min (MVmax40), 13CO2 cumulative excretion of 40 min (CUM40) and 120 min (CUM120) and used in a comparative analysis to determine association with Child-Pugh score, MELD score, liver and spleen volume (assessed by computed tomography), and liver function parameters (assessed by standard biochemical assays). Results As severity of liver damage increased, the MVmax40, CUM40, and CUM120 decreased. The 13C-MBT classification was consistent with Child-Pugh classification (κ=0.57, P＜0.05) and MELD classification (κ=0.41, P＜0.05). In cirrhosis patients, the 13C-MBT parameters were negatively correlated with Child-Pugh score, MELD score, total bilirubin, international normalized ratio, and spleen volume (all P＜0.01), but positively correlated with albumin, prealbumin, prothrombin time activity, and serum cholinesterase (all P＜0.05), and not correlated with creatinine, alanine aminotransferase, or liver volume (all P＞0.05). In 68 patients with hepatitis B virus infection and cirrhosis, the liver volumes were obviously reduced with increasing Child-Pugh score and MELD score. The 13C-MBT parameters were positively correlated with liver volume. Conclusion The 13C-methacetin breath test is a useful tool to measure the extent of hepatocyte injury and liver functional reserve.
【Key words】：13C-methacetin breath test; liver functional reserve; Child-Pugh classification; model for end-stage liver disease; liver cirrhosis