Application of Indocyanine Green Clearance Test in Portal Hypertension of Liver Dysfunction

DENG Changlin; ZHANG Shuping; HUANG Chaohong; LI Xiaoke; XU Hui

doi:10.13730/j.issn.1009-2595.2018.02.009

Abstract：Objective To assess the application value of indocyanine green ICG) clearance test in cirrhosis and portal hypertension of liver dysfunction.Methods The clinical data of 124 patients with cirrhosis and portal hypertension in author's hospital from April 2012 to June 2016 were collected and retrospectively analyzed.According to postoperative recovery of liver function,all patients were divided into liver dysfunction group (n =26) and better liver function group (n =98).Based on preoperative indocyanine green retention rate at 15 minute (ICGR15),patients were divided into 3 group,including ICGR15≤10％(n =40),10％＜ICGR15＜30％ (n=62) and ICGR15≥30％ (n =22).Clinical data were compared among three groups.The area under the curve (AUC) of receiver operating characteristic (ROC) was used to measure the accuracy of ICGR15 in predicting postoperative liver dysfunction in patients with cirrhosis and portal hypertension.Results Liver dysfunction occurred in 26 patients of 124 cirrhosis and portal hypertension patients,about 20.97％,and 1 patient died of liver failure,about 0.81％.The preoperative ICGR15 levels in the liver dysfunction group were higher than these in the better liver function group (P＜0.05).The AUC of ICGR15 in predicting postoperative liver dysfunction was 0.800 and the critical value was 18.6,with 84.6％ sensitivity and 67.3％ specificity.The incidences of postoperative liver dysfunction were 5.00％(2/40),22.58％ (14/62),45.45％ (10/22) in the group with ICGR15 ≤ 10％,10％＜ICGR15 ＜30％ and ICGR15≥30％,respectively.There were significantly differences in the incidences of postoperative liver dysfunction among three groups (P＜0.05).Conclusion Postoperative liver function recovery in cirrhotic patients with portal hypertension is associated with liver reserve function.ICGR15 is a good predictive indicator of postoperative liver dysfunction in patients with cirrhosis and portal hypertension.Patients with ICGR15 ≥30％ are more likely to occur postoperative liver dysfunction.