| Objective: Liver is an organ that posses multiple physiological function, great regeneration potential and compensation. A great deal of processes such as digestion, metabolism, detoxication, excretion and immunity are undertaken in liver. At present, how to evaluate hepatic function reserve accurately is a challenge in treatment of liver disease.There are many classical methods evaluating hepatic function reserve quantitatively, including Child classifying method of hepatic function, Child-Pugh classifying method, Safuji classifying method, and so on. ICG stress test is the popular method evaluating hepatic function reserve. In recent years, the quantitation of ASGP receptor by 99mTc-labeling neogalactoalbumin SPECT scintiscan is the up-to-date method that is applied to quantitatively evaluate hepatic function reserve. Literature reported that the capability of eliminating ASGP of the liver can be reflected more directly by this method, and correlative index can be applied to quantitatively evaluate hepatic function reserve. Analysing the surface ASGP receptor on separated liver cell by flow cytometer, and is a new method evaluating hepatic function reserve, however, this kind of study is still at its experiment stage. Asialofetuin (ASF) is the ligand of ASGP receptor residing on liver cell surface, can bind its receptor specifically and be degradateded by liver cell. Now ASF is applied to investigate ASGP receptor of liver extensively.Whether or not can the indocyanogen green retention rate test be combined effectively with the correlative index of liver ASGP receptor nuclin scanning, so that a more accurate and more sensitive method of evaluatingquantitatively hepatic function reserve can be selected.Aiming at above problems, the objective of this experiment is to discuss correlation between indices of SPECT liver ASGP receptor scintiscan with the ligand of 99mTc - ASF and classical liver functional index, and sensitivity of those indices. Further, we hope to choose a more sensitive parameter from those indices, and provide a guiding standard for clinical staff to select a quantitatively evaluation method of hepatic function reserve.Methods: Wistar rats (male) were used to establish a model of carbon tetrachloride inducing cirrhosis and differently proportional resection of rodent liver. Classical liver functional index, indocyanogen green retention rate test, 15min ligand clearance estimated by liver ASGP receptor nuclin scanning (HH15), liver uptaking rate (LHL15), modified receptor index (MRI), and in vitro analysis of ASGP receptor on liver cell surface detected by Flow cytometer were investigated respectively. The correlation and sensitivity of each index were discussed.The indices of differently damaged liver model and differently proportional resection of rodent liver such as Classical liver functional index, ICGR15,MRI,HH15,and LHL15,were be evaluated combined. And then a synthetic method including many indices of evaluating hepatic function reserve could be found out by regression analysis.Statistic methods: Statistic data were expressed as M SD. And those data were analysed by software of SPSS and Microsoft Excel. Single equation variance analysis, COX regression, linearity correlation analysis , and X2 test were undertaken. The test standard was p<0.05.Results: In the models of carbon tetrachloride inducing cirrhosis and differently proportional resection of rat liver, there was a significant correlation among commonly used indexes of hepatic functional reserve. The quantity of ASGP receptor of normal liver were significantly more than that of cihhorsisby FCM. In the 15% losing of hepatic dimension, the change of hepatic functional reserve can not be reflected by ICGR15,that means this index is not sensitive enough. The sensitivity of those indices was that MRI , HH15>ICGR15>LHL15.The regression equation of evaluating hepatic functional reserve was that Y= 33.188 MRI-44.844 HH15+24.032 LHL15 - 34.915 ICGR15, and it was sensitive. When the evaluation coeffic... |
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