目的 分析吲哚菁氯潴留率( ICG - R15)与肝硬化食管胃底曲张静脉破裂出血患者预后的关系.方法 应用吲哚菁氯排泄试验检测108例肝硬化食管胃底曲张静脉破裂出血患者,并根据ICG - R15分为3组,比较3组间1年内再出血率的差异.并用受试者工作特征曲线分析ICG - R15、终末期肝病模型(MELD)评分以及Child - Pugh评分预测肝硬化食管胃底曲张静脉破裂再出血的敏感度、特异度、约登指数及曲线下面积(AUROC),分析各评分标准对再出血的预见能力.结果 食管胃底静脉曲张破裂出血患者的再出血率随着ICG - R15的增高而增高,3组间有显著差异(P＜0.05).ICG - R15在判断再出血的敏感度最高达97.4％,特异度最高达75.0％,AUROC最大.结论 ICG - R15有助于预测肝硬化食管胃底曲张静脉破裂出血患者的再出血率.%Objective To evaluate the re - bleeding rate in patients with cirrhosis esophageal varices bleeding using retention rate of indocyanine green at fifteen minutes (ICG - R15). Methods A total of 108 patients were tested with ICG - R15. Based on the ICG -R15 .all patients were divided into three groups. The difference of the re - bleeding rate in one year was compared among the three groups. And for assessing the value of predicting re - bleeding rate in cirrhotic patients with esophageal varices bleeding, the ICG - R15 ,MELD score and Child - Pugh score were calculated and evaluated by calculating receiver operator characteristic ( ROC) curves, the sensitivity, the specificity,the Youden Index and the area under the AUROC curve. Results The incidence of re - bleeding was significantly different a-mong the three groups with ICG - R15 test (P < 0. 05 ). The ICG - R15 had sensitivity of 97. 4% , specificity of 75. 0% and the largest AUROC for predicting the incidence of re - bleeding in patients with cirrhosis esophageal varices bleeding. Conclusion The ICG - R15 is a good parameter for predicting the prognosis of cirrhotic patients with esophageal varices bleeding.
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