KINETICS OF INDOCYANINE GREEN REMOVAL FROM THE BLOOD *
KINETICS OF INDOCYANINE GREEN REMOVAL FROM THE BLOOD *
复制标题
从血液中去除吲哚菁绿的动力学*
DOI：
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发表时间：
1970
期刊：
影响因子：
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通讯作者：
C. M. Leevy
中科院分区：
文献类型：
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作者：
G. Paumgartner;P. Probst;R. Kraines;C. M. Leevy
从血液中去除染料的动力学研究极大地促进了我们对肝脏生理学的理解。主要用于研究肝循环和功能的染料是磺溴酞、玫瑰红和吲哚菁绿色（ICG）。本文将研究ICG在肝脏中的清除动力学。这种染料似乎主要与血清中的α 1-脂蛋白结合。“它不表现出肝外清除或肝肠硬化，在通过肝脏的过程中不发生化学变化2 9 4，并且在所用剂量下无毒。~使用双色耳密度计可以准确和连续地记录ICG血液水平。~不同剂量的ICG已被用于测试人类的肝功能，范围为0.25-5 mg/kg体重。清除0.25-0.5 mg ICG的研究在检测轻度肝脏疾病方面相对不敏感，而清除5.0 mg/kg该染料在这些情况下是一个高度敏感的肝功能指标^^。肝血流在低染料浓度下是限速的，并且每单位时间从循环中去除的ICG的量主要是肝血流的量度。在非常高的染料浓度下，肝细胞摄取染料的能力成为速率限制，在这些情况下ICG清除率代表了肝细胞功能的敏感指标。在临床上，不可能使用足够大剂量的染料来测量肝细胞不依赖于血流而清除ICG的能力。然而，如果肝脏对染料的摄取遵循Michaelis-Menten动力学，则应该可以从几个次最大值计算出最大清除能力。
Studies of kinetics of dye removal from the blood have greatly advanced our understanding of hepatic physiology. The dyes used mainly to investigate hepatic circulation and function are sulfobromophthalein, rose bengal and indocyanine green (ICG). This paper will be concerned with kinetics of hepatic removal of ICG. This dye appears to be bound primarily to alpha 1-lipoproteins in serum.' It does not exhibit extrahepatic removal or enterohepatic c i r c u l a t i ~ n , ~ ~ ~ is not chemically altered during its transit through the liver 2 9 4 and is nontoxic in the doses e m p l ~ y e d . ~ Accurate and continous recording of ICG blood levels is possible using dichromatic ear den~itometry.~ Different doses of ICG have been used to test liver function in man, ranging from 0.25-5 mg/kg body weight. Studies of clearance of 0.25-0.5 mg of ICG are relatively insensitive in detecting mild liver disease, whereas removal of 5.0 mg/kg of this dye furnishes a highly sensitive index to hepatic function in these instance^.^ Liver blood flow is rate limiting with low dye concentrations, and the amount of ICG removed from the circulation per unit of time is primarily a measure of liver blood flow. The ability of hepatocytes to take up dye becomes rate limiting at very high dye concentrations, and ICG clearance under these circumstances represents a sensitive measure of liver cell function. Clinically, it is not possible to use a sufficiently large dose of dye to measure capacity of hepatocytes to remove ICG independent of blood flow. Nevertheless, it should be possible to calculate maximal removal capacity from several submaximal values if hepatic uptake of dyes obeys Michaelis-Menten kinetics.