吲哚菁绿15分钟滞留率对HBV相关慢加急性肝衰竭患者病情及预后的评估价值

刘精华; 刘娜; 刘晨希

doi:10.3969/j.issn.1001-5256.2016.11.031

吲哚菁绿15分钟滞留率对HBV相关慢加急性肝衰竭患者病情及预后的评估价值

DOI: 10.3969/j.issn.1001-5256.2016.11.031

中国医科大学附属盛京医院

详细信息

中图分类号: R512.62;R575.3
计量
- 文章访问数: 2094
- HTML全文浏览量: 21
- PDF下载量: 465
- 被引次数: 0
出版历程
- 出版日期: 2016-11-20

Clinical value of indocyanine green retention rate in condition analysis and prognostic evaluation of patients with HBV-related acute-on-chronic liver failure

摘要

摘要:
目的分析吲哚菁绿15 min滞留率（ICG R15）对慢加急性肝衰竭（ACLF）病情及临床预后的评估价值,为ACLF患者的病情评估及预后评价提供参考指标。方法以中国医科大学附属盛京医院2013年8月-2016年1月收治的127例ACLF患者为研究对象,按照临床分期分为早期组、中期组、晚期组,比较不同临床分期患者ICG R15、MELD评分及PT的差异,并按照患者90 d预后分为存活组、死亡组,比较两组患者上述指标间差异,总结ICG R15评价患者病情及预后的临床价值。计量资料组间比较采用独立样本t检验或单因素方差分析,采用LSD-t检验进行两两比较;计数资料组间比较采用χ2检验。结果不同临床分期组间ICG R15、PT、MELD评分差异均有统计学意义（F值分别为7.036、3.217、5.883,P值均<0.05）,其中中期组、晚期组ICG R15、PT、MELD评分[（53.96±10.01）%、（26.87±6.84）s、（31.56±4.17）分,（54.23±9.21）%、（28.43±3.61）s、（32.87±3.28）分]均高于早期组[（44.00±9.21）%、（...
- 肝功能衰竭 /
- 吲哚花青绿 /
- 预后
Abstract:
Objective To investigate the clinical value of indocyanine green retention rate at 15 min( ICG R15) in the condition analysis and prognostic evaluation of patients with acute- on- chronic liver failure( ACLF),and to provide a reference index for condition analysis and prognostic evaluation of patients with ACLF. Methods A total of 127 ACLF patients who were admitted to our hospital from August2013 to January 2016 were enrolled,and according to the clinical stage,they were divided into early- stage group,medium- stage group,and late- stage group. The ICG R15,Model for End- Stage Liver Disease( MELD) score,and prothrombin time( PT) were compared between the patients with different clinical stages. According to the prognosis at 90 days,the patients were divided into survival group and death group,and the above indicators were compared between the two groups. The clinical value of ICG R15 in condition analysis and prognostic evaluation was summarized. The independent samples t- test or a one- way analysis of variance was used for continuous data,the least significant difference method was used for comparison between any two groups,and the chi- square test was used for categorical data.Results Compared with the early- stage group,the medium- stage group and late- stage group had significantly higher ICG R15( 53. 96% ±10. 01% /54. 23% ± 9. 21% vs 44. 00% ± 9. 21%,P < 0. 05),PT( 26. 87 ± 6. 84 s /28. 43 ± 3. 61 s vs 19. 79 ± 2. 82 s,P < 0. 05),and MELD score( 31. 56 ± 4. 17 /32. 87 ± 3. 28 vs 24. 00 ± 3. 85,P < 0. 05). The death group had significantly higher ICG R15,PT,and MELD score than the survival group( ICG R15: 53. 91% ± 5. 83% vs 45. 03% ± 4. 33%,t = 9. 85,P < 0. 05; PT: 29. 85 ± 3. 52 s vs 21. 35 ± 3.18 s,t = 14. 20,P < 0. 05; MELD score: 33. 81 ± 4. 67 vs 25. 30 ± 4. 02,t = 10. 99,P < 0. 05). With an ICG R15 of 52%,a PT of 29 s,and a MELD score of 32 as cut- off values,there were significant differences in mortality rate between the patients with different levels of indicators( ICG R15: 22. 39% vs 64. 29%,χ2= 8. 831,P < 0. 05; PT: 25. 71% vs 61. 40%,χ2= 6. 263,P < 0. 05; MELD score: 21. 54% vs 62. 90%,χ2= 7. 583,P < 0. 05). Conclusion With the aggravation of the condition of ACLF and the reduction in prognosis,PT and MELD score increase gradually,and ICG R15 also increases. We can comprehensively evaluate patients' condition and clinical prognosis in an early stage based on the changes in the above indicators.
- liver failure /
- indocyanine green /
- prognosis

HTML全文

参考文献(13)

[1]WANG HM,WANG JM,YAN L.Clinical application of liver function test in evaluating the liver reserve function[J/CD].E-J Transl Med,2015,2(11):46-47.(in Chinese)王惠梅,王菊梅,燕磊.肝功能检查在评估肝储备功能方面的临床应用分析[J/CD].转化医学电子杂志,2015,2(11):46-47.

[2]FENG HL,LI Q,WANG L,et al.Indocyanine green clearance test combined with MELD score in predicting the shortterm prognosis of patients with acute liver failure[J].Hepatobiliary Pancreat Dis Int,2014,13(3):271-275.

[3] Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association;Severe Liver Diseases and Artificial Liver Group,Chinese Society of Hepatology,Chinese Medical Association.Guidelines for diagnosis and treatment liver failure[J].Chin J Clin Infect Dis,2012,5(6):321-327.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华临床感染病杂志,2012,5(6):321-327.

[4]HOEKSTRA LT,de GRAAF W,NIBOURG GA,et al.Physiological and biochemical basis of clinical liver function tests:a review[J].Ann Surg,2013,257(1):27-36.

[5]LUO Y,HONG GH,LUO XH.Association between indocyanine green clearance test and chronic liver failure[J].Chongqing Med,2014,43(25):3357-3359.(in Chinese)罗燕,洪国祜,罗新华.吲哚氰绿清除实验与慢性肝功能衰竭的相关性分析[J].重庆医学,2014,43(25):3357-3359.

[6]HU MH,MA CY,CHEN L,et al.Preoperative application of malignant obstructive jaundice by indocyanine green excretion test[J].Chin J Clin Pharmacol Ther,2016,21(5):543-547.(in Chinese)胡明华,马晨阳,陈琳,等.吲哚菁绿清除实验在恶性阻塞性黄疸患者术前的应用[J].中国临床药理学与治疗学,2016,21(5):543-547.

[7]GUO J,ZHANG JF,YI WJ,et al.Value of indocyanine green clearance test in diagnosis and evaluation of chronic liver diseases[J].Chin J Integr Tradit West Med Liver Dis,2015,25(2):106-107.(in Chinese)郭静,张锦峰,仪文静,等.吲哚菁绿清除试验在慢性肝病诊断及评估中的价值[J].中西医结合肝病杂志,2015,25(2):106-107.

[8]LIU TZ,LUO XH.Value of indocyanine green clearance test in evaluation of liver reserve function in patients with decompensated liver cirrhosis[J].Guizhou Med J,2014,38(7):652-654.(in Chinese)刘天昭,罗新华.吲哚氰绿清除试验评估肝硬化失代偿期患者肝脏储备功能的价值[J].贵州医药,2014,38(7):652-654.

[9]WONG JS,WONG GL,CHAN AW,et al.Liver stiffness measurement by transient elastography as a predictor on posthepatectomy outcomes[J].Ann Surg,2013,257(5):922-928.

[10]KIM JM,KWON CH,JOH JW,et al.Can the model for endstage liver disease score replace the indocyanine green clearance test in the selection of right hemihepatectomy in Child-Pugh class A?[J].Ann Surg Treat Res,2014,86(3):122-129.

[11]DONG JH,TANG MS,ZHANG WZ,et al.Effects of concept and techniques of precision liver surgery on the perioperative safety of patients undergoing major hepatectomy[J].Chin J Dig Surg,2013,12(5):344-351.(in Chinese)董家鸿,唐茂盛,张文智,等.精准肝脏外科理念和技术对大范围肝切除围手术期安全性的影响[J].中华消化外科杂志,2013,12(5):344-351.

[12]VOS JJ,SCHEEREN TW,LUKES DJ,et al.Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation[J].J Clin Monit Comput,2013,27(5):591-598.

[13]ECKMANN K,MICHAUD LB,RIVERA E,et al.Pilot study to assess toxicity and pharmacokinetics of docetaxel in patients with metastatic breast cancer and impaired liver function secondary to hepatic metastases[J].J Oncol Pharm Pract,2014,20(2):120-129.

施引文献

资源附件(0)

访问统计