ICG排泄试验评估肝脏储备功能的进一步研究
发布时间：2021-01-26 19:45
背景与目的肝细胞癌（Hepatocellular carcinoma,HCC）是人类最常见的恶性肿瘤之一,手术治疗是其最重要的治疗方法。术前肝脏储备功能评估则是决定手术方案、预测手术预后的重要环节,其中吲哚菁绿（Indocyaninegreen,ICG）排泄试验是应用最广泛的定量肝功能试验。以往的研究已表明ICG的15分钟残留率（ICG retention value at 15min,ICG R15）在评估肝癌切除患者预后方面有着重要价值。本研究旨在探索ICG排泄试验相关指标包括ICG的5分钟残留率（ICGR5）、10分钟残留率（ICG R10）、15分钟残留率（ICG R15）、ICG血浆清除率（ICG serum disappearance rate,ICGK）、半衰期（T1/2）、有效肝血流量（Effectivehepaticbloodflow,EHBF）等在肝癌术后住院时间、是否发生肝功能衰竭以及射频消融术后远期生存的预测价值。方法本研究收集了浙江大学医学院附属第二医院2014年10月至2017年6月的所有接受ICG排泄试验的356名肝细胞癌患者的临床资料,回顾性分析了 IC...
【文章来源】：浙江大学浙江省 211工程院校 985工程院校 教育部直属院校
【文章页数】：103 页
【学位级别】：博士
【部分图文】：
图２．２?ＩＣＧ?Ｒ１５与ＭＥＬＤ评分、ＡＬＢＩ评分ＲＯＣ曲线对比??２．６．２肝脏切除术??
ＯＲ：?Ｏｄｄ?ｒａｔｉｏ比值比；９５％ＣＩ：?９５％置信区间??将?ＩＣＧ?排泄试验相关指标?ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＲ１５、ＩＣＧＫ、Ｔ１／２、ＥＨＢＦ??与射频消融术后是否发生肝衰竭做ＲＯＣ曲线（图２．３），并与ＭＥＬＤ评分、ＡＬＢＩ??评分做对比（图?２．４）。可以看到?ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＲ１５、ＩＣＧＫ、Ｔ１／２、ＥＨＢＦ??六个指标曲线下面积相近，相互之间无显著性差异（ｐ＞〇．〇５），且均高于ＭＥＬＤ评??分与ＡＬＢＩ评分。其中ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＫ、ＴＩ／２也因为高度相关，ＲＯＣ曲??线几乎重合，ＡＵＣ均为０．７１７，?ｐ值也均小于０．００１。八个指标中，ＩＣＧＲ１５的ＡＵＣ??最高，为０．７１８，显著高于ＭＥＬＤ评分（；？＜０．００１）与ＡＬＢＩ评分（产０．００３），其??临界值为６．４５％
?ｆ?异性??图２．３?ＩＣＧ试验相关参数预测肝脏切除术后发生ＰＨＬＦ的ＲＯＣ曲线??ａ．?ＩＣＧＲ５；?ｂ．?ＩＣＧＲ１０；?ｃ．?ＩＣＧＲ１５；?ｄ．?ＩＣＧ?Ｋ；?ｅ．?Ｔ１／２；?ｆ．?ＥＨＢＦ??３１??
【参考文献】：
期刊论文
[1]Effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats: What we know so far?[J]. Antonios Athanasiou,Eleftherios Spartalis,Mairead Hennessy,Michael Spartalis,Demetrios Moris,Christos Damaskos,Emmanouil Pikoulis. Hepatobiliary & Pancreatic Diseases International. 2018(01)
[2]Perioperative fluid management in major hepatic resection: an integrative review[J]. Osamu Yoshino,Marcos Vinicius Perini,Christopher Christophi,Laurence Weinberg. Hepatobiliary & Pancreatic Diseases International. 2017(05)
[3]Serum prealbumin as an effective prognostic indicator for determining clinical status and prognosis in patients with hemorrhagic stroke[J]. Shen-qi Zhang,Bin Peng,Creed M.Stary,Zhi-hong Jian,Xiao-xing Xiong,Qian-xue Chen. Neural Regeneration Research. 2017(07)
[4]Update on diagnostic value of breath test in gastrointestinal and liver diseases[J]. Imran Siddiqui,Sibtain Ahmed,Shahab Abid. World Journal of Gastrointestinal Pathophysiology. 2016(03)
[5]CT/99mTc-GSA SPECT fusion images demonstrate functional differences between the liver lobes[J]. Tatsuaki Sumiyoshi,Yasuo Shima,Ryoutarou Tokorodani,Takehiro Okabayashi,Akihito Kozuki,Yasuhiro Hata,Yoshihiro Noda,Yoriko Murata,Toshio Nakamura,Kiminori Uka. World Journal of Gastroenterology. 2013(21)
[6]肝脏定量肝功能试验方法及研究进展[J]. 余胜锋,张捷,付必莽. 医学综述. 2011(07)
[7]肝癌射频消融治疗规范的专家共识[J]. 陈敏山,陈敏华. 临床肝胆病杂志. 2011(03)
[8]Small-for-size syndrome in adult-to-adult living-related liver transplantation[J]. Salvatore Gruttadauria,Duilio Pagano,Angelo Luca,Bruno Gridelli. World Journal of Gastroenterology. 2010(40)
[9]Clinical practice guidelines for hepatocellular carcinoma:the first evidence based guidelines from Japan[J]. Masatoshi Makuuchi,Norihiro Kokudo. World Journal of Gastroenterology. 2006(05)
[10]Functional hepatic flow in patients with liver cirrhosis[J]. Zheng Pan Xing-Jiang Wu Jie-Shou Li Fang-Nan Liu WeiSu Li Jian-Ming Han Research Institute of General Surgery,Nanjing General Hospital of Nanjing Command/Clinical School of Medical College of Nanjing University,Nanjing 210002,Jiangsu Province,China. World Journal of Gastroenterology. 2004(06)
本文编号：3001712
【文章来源】：浙江大学浙江省 211工程院校 985工程院校 教育部直属院校
【文章页数】：103 页
【学位级别】：博士
【部分图文】：
图２．２?ＩＣＧ?Ｒ１５与ＭＥＬＤ评分、ＡＬＢＩ评分ＲＯＣ曲线对比??２．６．２肝脏切除术??
ＯＲ：?Ｏｄｄ?ｒａｔｉｏ比值比；９５％ＣＩ：?９５％置信区间??将?ＩＣＧ?排泄试验相关指标?ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＲ１５、ＩＣＧＫ、Ｔ１／２、ＥＨＢＦ??与射频消融术后是否发生肝衰竭做ＲＯＣ曲线（图２．３），并与ＭＥＬＤ评分、ＡＬＢＩ??评分做对比（图?２．４）。可以看到?ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＲ１５、ＩＣＧＫ、Ｔ１／２、ＥＨＢＦ??六个指标曲线下面积相近，相互之间无显著性差异（ｐ＞〇．〇５），且均高于ＭＥＬＤ评??分与ＡＬＢＩ评分。其中ＩＣＧＲ５、ＩＣＧＲ１０、ＩＣＧＫ、ＴＩ／２也因为高度相关，ＲＯＣ曲??线几乎重合，ＡＵＣ均为０．７１７，?ｐ值也均小于０．００１。八个指标中，ＩＣＧＲ１５的ＡＵＣ??最高，为０．７１８，显著高于ＭＥＬＤ评分（；？＜０．００１）与ＡＬＢＩ评分（产０．００３），其??临界值为６．４５％
?ｆ?异性??图２．３?ＩＣＧ试验相关参数预测肝脏切除术后发生ＰＨＬＦ的ＲＯＣ曲线??ａ．?ＩＣＧＲ５；?ｂ．?ＩＣＧＲ１０；?ｃ．?ＩＣＧＲ１５；?ｄ．?ＩＣＧ?Ｋ；?ｅ．?Ｔ１／２；?ｆ．?ＥＨＢＦ??３１??
【参考文献】：
期刊论文
[1]Effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats: What we know so far?[J]. Antonios Athanasiou,Eleftherios Spartalis,Mairead Hennessy,Michael Spartalis,Demetrios Moris,Christos Damaskos,Emmanouil Pikoulis. Hepatobiliary & Pancreatic Diseases International. 2018(01)
[2]Perioperative fluid management in major hepatic resection: an integrative review[J]. Osamu Yoshino,Marcos Vinicius Perini,Christopher Christophi,Laurence Weinberg. Hepatobiliary & Pancreatic Diseases International. 2017(05)
[3]Serum prealbumin as an effective prognostic indicator for determining clinical status and prognosis in patients with hemorrhagic stroke[J]. Shen-qi Zhang,Bin Peng,Creed M.Stary,Zhi-hong Jian,Xiao-xing Xiong,Qian-xue Chen. Neural Regeneration Research. 2017(07)
[4]Update on diagnostic value of breath test in gastrointestinal and liver diseases[J]. Imran Siddiqui,Sibtain Ahmed,Shahab Abid. World Journal of Gastrointestinal Pathophysiology. 2016(03)
[5]CT/99mTc-GSA SPECT fusion images demonstrate functional differences between the liver lobes[J]. Tatsuaki Sumiyoshi,Yasuo Shima,Ryoutarou Tokorodani,Takehiro Okabayashi,Akihito Kozuki,Yasuhiro Hata,Yoshihiro Noda,Yoriko Murata,Toshio Nakamura,Kiminori Uka. World Journal of Gastroenterology. 2013(21)
[6]肝脏定量肝功能试验方法及研究进展[J]. 余胜锋,张捷,付必莽. 医学综述. 2011(07)
[7]肝癌射频消融治疗规范的专家共识[J]. 陈敏山,陈敏华. 临床肝胆病杂志. 2011(03)
[8]Small-for-size syndrome in adult-to-adult living-related liver transplantation[J]. Salvatore Gruttadauria,Duilio Pagano,Angelo Luca,Bruno Gridelli. World Journal of Gastroenterology. 2010(40)
[9]Clinical practice guidelines for hepatocellular carcinoma:the first evidence based guidelines from Japan[J]. Masatoshi Makuuchi,Norihiro Kokudo. World Journal of Gastroenterology. 2006(05)
[10]Functional hepatic flow in patients with liver cirrhosis[J]. Zheng Pan Xing-Jiang Wu Jie-Shou Li Fang-Nan Liu WeiSu Li Jian-Ming Han Research Institute of General Surgery,Nanjing General Hospital of Nanjing Command/Clinical School of Medical College of Nanjing University,Nanjing 210002,Jiangsu Province,China. World Journal of Gastroenterology. 2004(06)
本文编号：3001712
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