【摘要】：目的：研究肝硬化患者吲哚菁綠清除試驗與MELD評分之間關系。ICG清除試驗中清除率(K)和肝內15分鐘內保留率(R15)是評估患者肝臟功能的敏感指標,終末期肝病模型(MELD)評分是評估等待肝移植患者死亡率的有效方法,已廣泛應用于臨床。本研究通過回顧性分析研究肝硬化患者清除率試驗(K值、R15值)、MELD評分與Child-Pugh評分之間的相關性及其臨床意義。方法：回顧性分析2012年6月至2013年6月共78例被我科診斷為肝硬化患者,根據Child-Pugh分級分為A、B、C三組,ICG試驗中K值和R15值是由脈沖分光光度法(DDG-3300K)測出,MELD評分是根據MELD評分公式計算得出。A、B、C三組組間采用兩獨立樣本t檢驗,ICG清除試驗和MELD評分之間采用spearman相關性分析。結果：患者在A、B、C三組中K值、R15及MELD評分各組間經t檢驗有顯著的統(tǒng)計學差異。K值在A組中最大,為0.15±0.06,C組中最小,為0.07±0.04。R15在C組中最大,為38.1±15.6,在A組中最小12.5±10.2,MELD評分在C組中最大,為12.5±5.6,A組中最小,為3.9±3.7。各組間采用兩樣本t檢驗,在A組、B組與C組比較中,k值、R15、MELD評分各組均有統(tǒng)計學意義(P0.05)。ICG清除試驗(K值和R15)與MELD評分之間經直線相關性分析有著顯著的相關性,K值與MELD評分之間呈負相關(r=-0.443,P0.01),而R15和MELD評分之間呈正相關(r=0.478,P0.01),K值與R15之間呈負相關性(r=-0.666,P0.01)。K值、R15、MELD評分與Child-Pugh評分之間經直線相關性分析示：Child-Pugh評分與K值、R15、MELD評分之間存在顯著的相關性,它與K值呈負相關(r=Child-Pugh評分-0.599,P0.01),與R15呈正相關(r=Child-Pugh評分0.475,P0.01),與MELD評分亦呈正相關(r=Child-Pugh評分0.626,P0.01)。結論：根據Child-Pugh評分分組,ICG清除試驗(K值和R15)與MELD評分之間存在顯著相關性,其中R15值,可能是評價肝硬化患者肝功能合適的指標。
[Abstract]:Objective: to study the relationship between indocyanine green clearance test and MELD score in patients with liver cirrhosis. The clearance rate (K) and intrahepatic retention rate (R15) in ICG clearance test were sensitive indexes for evaluating liver function in patients with liver cirrhosis. The (MELD) score of end-stage liver disease model is an effective method to evaluate the mortality of patients waiting for liver transplantation and has been widely used in clinic. In this study, the correlation and clinical significance of clearance test (K value, R15), MELD score and Child-Pugh score) in patients with liver cirrhosis were analyzed retrospectively. Methods: from June 2012 to June 2013, 78 patients with liver cirrhosis diagnosed by our department were divided into three groups according to Child-Pugh classification: group A, group B, group C. The values of K and R15 in ICG test were determined by pulse spectrophotometry (DDG-3300K). The MELD score was calculated according to the MELD score formula. A, B, C groups were tested by two independent samples t test, ICG clearance test and MELD score were analyzed by spearman correlation analysis. Results: in group A, B, C, the scores of K, R15 and MELD were significantly different by t test. K value was the largest in group A (0. 15 鹵0. 06), the smallest in group C (0. 07 鹵0.04.R15), the largest in group C (0. 15 鹵0. 06), and the lowest in group C (0. 07 鹵0. 06), the highest in group C (0. 15 鹵0. 06). It was 38.1 鹵15.6 in group A, 12.5 鹵10.2 in group A, and 12.5 鹵5.6 in group C and 3.9 鹵3.7 in group A, respectively. In group A, group B and group C, the value of k, R15, and so on, were compared with each other by two-sample t-test. There was a significant correlation between MELD clearance test (K value and R15) and MELD score (P 0.05). There was a negative correlation between K value and MELD score (r = 0.443, P0.01). There was a positive correlation between R15 and MELD score (r = 0.478, P0.01), and a negative correlation between K value and R15 score (r = 0.666, P0.01). The linear correlation analysis between MELD score and Child-Pugh score showed that there was a significant correlation between Child-Pugh score and K value, R15, meld score, and it was negatively correlated with K value (r=Child-Pugh score-0.599, P0.01). There was a positive correlation between R15 and R15 (r=Child-Pugh score 0.475, P0.01) and MELD score (r=Child-Pugh score 0.626, P0.01). Conclusion: according to Child-Pugh score, there is a significant correlation between ICG clearance test (K value and R15) and MELD score, in which R15 value may be an appropriate index to evaluate liver function in patients with liver cirrhosis.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R575.2

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本文編號：2435382