To Explore The Application Value And Correlation Of Indocyanine Green Clearance Test In Severe Hepatitis And Cirrhosis

Objective: By observing the parameter value of indocyanine green 15 min retention rate(ICG R15),15 min clearance(K),effective liver blood flow(EHBF)in indocyanine green clearance test in patients with severe hepatitis and cirrhosis,and their relationship with other commonly used liver function assessment indicators,we can investigate the clinical application value and correlation of ICG clearance test in evaluating liver reserve function in patients with severe hepatitis and cirrhosis.Methods: Pulse density analysis(PDD method)was used in 78 patients with endstage liver disease.ICG R15,K,and EHBF were detected at the time of admission,and clinical routine liver function biochemical examination and imaging examination were improved at the same time.Then we calculated its Child-Pugh classification and end-stage liver disease assessment model(MELD score)based on the results.Data between groups were tested by independent factor t test,P <0.05 was statistically significant.Regression analysis and F test(P <0.05)were used to compare the correlation among the ICG R15,K,and EHBF with Child-Pugh and MELD scores.We selected 40 patients with liver cirrhosis,and explored the change of ICGR15,K,EHBF and MELD scores and their relationship between the compensated group and decompensated group.We Selected 38 patients with severe hepatitis,and followed-up for 3 months after diagnosis to determine their re-admission rate or mortality rat,and used the receiver operating characteristic curve(ROC)to evaluate the ability of R15,K,EHBF,MELD score,and CTP score about identifying and predicting prognosis of severe hepatitis.Results:(1)Among the three groups,the R15 value of the Child A group was 18.652±11.613,the K value was 0.128±0.045,and the EHBF value was 0.496±0.220;the R15 value of the Child B group was 36.120±16.174,K was 0.089±0.077,and EHBF The value was 0.347 ± 0.169;the R15 value of the Child C group was 53.545 ± 10.925,the K value was 0.046±0.0201,the EHBF value was 0.177±0.082,and P <0.05 between the groups.ICG R15 and Child-Pugh classification have a positive correlation with a regression coefficient of 0.709;EHBF and K values have a negative correlation with Child-Pugh classification with a regression coefficient of 0.499 and 0.615,respectively;ICG R15 has a positive correlation with the MELD score.The regression coefficient was 0.684;the EHBF and K values were negatively correlated with the MELD score,and the regression coefficients were 0.566 and 0.599,respectively,P <0.05.(2)The mean ICG R15,K value,and EHBF of compensatory cirrhosis patients were18.39%,0.125,and 0.516,and the mean value of MELD score was 13.3 points.The mean values of ICG R15,K value,and EHBF were It was 43.29,0.079,0.248,and the mean value of MELD score was 16.8,which was statistically significant between each group(P <0.05).(3)There were no deaths in 38 patients with severe hepatitis during follow-up,and 6patients with poor prognosis,and ICG R15 values were greater than 50%;(4)The ROC curves of ICG R15,K,EHBF and MELD scores and CTP scores of patients with severe hepatitis were plotted,and the area under the curve(AUC)of each index was calculated to be 73.9%,23.9%,16.4%,57.1%,67.5%,of which The CTP score was not statistically significant(P> 0.05).Conclusion:(1)In the ICG clearance test,each parameter has significant correlation with ChildPugh classification and MELD evaluation model.Among them,ICG R15 is a positive correlation,K value and EHBF are both negative correlation,and ICG R15 correlation is The best,followed by EHBF,and finally the K value.It shows that R15,K value and EHBF are all sensitive indicators for evaluating liver reserve function,and R15 is the most representative.(2)The ICG clearance test can be used to assess liver reserve function in patients with cirrhosis.The mean ICG R15 value increases with the severity of cirrhosis,and the K value and EHBF are reversed.,and the liver damage reflected by each parameter is consistent with the result obtained by the MELD score.(3)To a certain extent,the probability of poor prognosis has been significantly increased when patients with severe hepatitis had ICG R15> 50%.(4)The ICG clearance test has a prominent advantage in predicting the prognosis of patients with severe hepatitis.Its ability to identify and predict severe hepatitis is the same as the MELD assessment model.Among them,ICG R15 has the strongest prognostic assessment ability.