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肝血流对肝功能有重要意义,亦关系到肝脏的生理学及临床药理学问题。测定肝血流率(Q)历来采用Bradly等倡导的方法,即持续滴注一种染料(多用吲哚氰绿ICG)(i),再测定周围动脉(A)及肝静脉血(V)中的ICG浓度;Q=(A-V)/A,按Fick’s原理计算而得。其后有人将其简化为持续滴注或单剂注入ICG后测算清除率(CI)来表示肝血流率,假定ICG在体内完全由肝脏摄取。但该项测算受方法学的限制,其合理性须待验证,例如在持续滴注中不能保证稳态(不与时间相关的ICG浓度),ICG血浓度常可随时间而增高。本文目的为验算这种非稳态的持续滴注对计算肝血流率及ICG清除率的影响,进而重新评价ICG清除率作为肝血流率的可行性。研究方法:计算浓度-时间曲线,用线性回归方法评定,取得动脉(A)及静脉(V)的平均ICG浓度及
Liver blood flow is of great importance to liver function, also related to the physiology and clinical pharmacology of the liver. The measurement of hepatic blood flow (Q) has historically been based on a method advocated by Bradly et al., In which continuous instillation of one dye (indocyanine green ICG) (i) and subsequent determination of peripheral arteries (A) and hepatic venous blood ICG concentration; Q = (AV) / A, calculated according to Fick’s principle. Later, it was simplified as continuous infusion or single dose injection of ICG clearance (CI) to indicate the rate of hepatic blood flow, given the ICG in the body completely uptake by the liver. However, this calculation is subject to methodological limitations and its rationale remains to be verified. For example, steady-state (non-time-dependent concentration of ICG) can not be guaranteed for continuous infusion. ICG blood concentration can often increase over time. The aim of this paper is to examine the effect of this unsteady continuous infusion on the calculation of hepatic blood flow rate and ICG clearance, and to re-evaluate the feasibility of ICG clearance as a hepatic blood flow rate. Research Methods: Concentration-time curves were calculated and assessed by linear regression to obtain mean ICG concentrations of arterial (A) and venous (V)