Indocyanine Greenに関する臨床的研究
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概要
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The metabolism and clinical analysis of Indocyanine Green (ICG), a derivative of Tricarbocyanines in hepatic disorders are reported. ICG disappearance rate from serum (K) : was 0.186±0.056 in normal person, 0.133±0.026 in patient with acute hepatitis, 0.155±0.032 in chronic hepatitis and 0.059±0.015 in cirrhosis. Both extra and intrahepatic obstructive jaundice showed remarkably low rate. The rate was almost normal in Gilbert disease with some exceptions and was normal in Dubin-Johnson syndrome, however, it was conspicuously decreased in Rotor type. To simplify the examination procedure blood specimen was collected only once and its result was studied. It was found that specimen at 15min. after injection was the most suitable in separating normal and abnormal groups. By this method, normal rate was 6.09±0.54% and over 10% indicated abnormal condition. Correlation between ICG disappearance rate and BSP (30min.) retention rate showed positive and r was -0.67 (p<0.01). There was no clear correlation observed with other liver function test. ICG and BSP dissociation was also observed in some instances. ICG turned normal more rapid than BSP, ICG sharply reflected the pathological status of cirrhosis comparing with BSP. Transport maximum (Tm) and relative storage capacity (S) in the liver cell were 0.96mg/min. and 104.2mg/mg% respectively. In chronic hepatitis, Tm was 0.69 and S was 117.2. Dubin-Johnson syndrome showed decreased Tm and increased S and Rotor type showed remarkably low Tm and S as well as K. It is clearly apparent that ICG test is the most excellent method to differentiate Dubin-Johnson syndrome and Rotor type.
- 千葉大学の論文