The Clinical Value Of Indocyanine Green Clearance Test In Evaluating The Progression Of Chronic Liver Disease

Objective:To estimate the value of indocyanine green(ICG)clearance test in the assessment for liver reserve function in patients with different degrees of chronic liver diseases.Methods:A total of 87 patients with liver diseases who were hospitalized in the Department of Infectious Diseases,the First Hospital of Shanxi Medical University from November2017 to August 2019 were enrolled.ICG retention rate at 15 min(ICG-R15)、ICG plasma clearance rate(K value)and effective hepatic blood flow(EHBF)were measured by DDG-3300 K analyzer(Japan).Meanwhile,all the patients received test of hepatic function,routine analysis of blood,abdominal color Doppler ultrasound,abdominal CT or MRI.The Child-Turcotte-Pugh(CTP)scores were calculated for classification.An analysis of variance was used for comparison between groups,the least significant difference t-test was used for comparison between any two groups.Results:ICG-R15,K value and EHBF were significantly different among chronic hepatitis,liver cirrhosis and chronic liver failure groups(F=40.767,F=42.558,F=25.822,P<0.05);The ICG-R15,K value and EHBF were[(7.4±1.7)%,(0.22±0.05)/min and(0.9±0.3)L/min] in chronic hepatitis group,[(12.2±2.8)%,(0.16±0.05)/min and(0.7±0.2)L/min] in liver cirrhosis CTP Agroup,[(28.8±12.6)%,(0.10±0.03)/min and(0.4±0.2)L/min] in CTP B group,[(39.3±8.9)%,(0.06±0.02)/min and(0.3±0.1)L/min] in CTP C group,[(54.2±11.6)%,(0.04±0.01)/min and 0.2±0.1)L/min] in chronic liver failure group,except that there was no significant difference between liver cirrhosis CTP C group and chronic liver failure group(P>0.05),there was significant difference between the other groups(P<0.05);The differences of major indicators of hepatic function in different ICG-R15 level groups showed that ALB and PTA were statistically different(F=30.966,F=24.058,P<0.05).Conclusion:The ICG clearance test can dynamically reflect liver reserve function,make up for the deficiency of CTP classification,and try to serve as a reference index for early diagnosis of liver cirrhosis.The evaluation value of "liver cirrohosis re-compensation" deserves further study.