Value of indocyanine green test in evaluating liver reserve function in patients with hepatitis B cirrhosis

Objective To evaluate liver reserve function in patients with hepatitis B cirrhosis using indocyanine green( ICG) clearance test,and to investigate the correlation of ICG clearance test with Child- Turcotte- Pugh( CTP) class and the Model for End- Stage Liver Disease( MELD) score in evaluating liver function. Methods A total of 127 patients with hepatitis B cirrhosis who were hospitalized in The First Affiliated Hospital of Fujian Medical University from January 2012 to January 2015 were enrolled. ICG clearance test was performed for all the patients,and the ICG plasma clearance( K value),effective liver blood flow( EHBF),and ICG retention at 15 minutes( ICG R15)were calculated. CTP class and MELD score were also determined. An analysis of variance was used for comparison between groups,the least significant difference t- test was used for comparison between any two groups,Spearman rank correlation was performed for correlation analysis,and the area under the receiver operating characteristic( ROC) curve was used to compare liver reserve function. Results Among all the patients with hepatitis B cirrhosis,63 had CTP class A,45 had CTP class B,and 19 had CTP class C hepatitis B cirrhosis. With the increasing CTP class,ICG R15 gradually increased,while EHBF and K value gradually decreased( F = 146. 96,91. 26 and 40. 94,P =0. 001,0. 003 and 0. 005). In the evaluation of liver function,ICG R15 was positively correlated with MELD score and CTP class( r = 0. 525 and 0. 838,both P < 0. 01) and was negatively correlated with EHBF and K value( r =- 0. 703 and- 0. 901,both P < 0. 01). The area under the ROC curve was 0. 85 for ICG R15 and 0. 65 for MELD score. Conclusion ICG test can accurately and dynamically reflect liver reserve function,and ICG R15 can evaluate liver reserve function better than CTP class and MELD score.