Clinical value of indocyanine green retention rate in condition analysis and prognostic evaluation of patients with HBV-related acute-on-chronic liver failure

Objective To investigate the clinical value of indocyanine green retention rate at 15 min( ICG R15) in the condition analysis and prognostic evaluation of patients with acute- on- chronic liver failure( ACLF),and to provide a reference index for condition analysis and prognostic evaluation of patients with ACLF. Methods A total of 127 ACLF patients who were admitted to our hospital from August2013 to January 2016 were enrolled,and according to the clinical stage,they were divided into early- stage group,medium- stage group,and late- stage group. The ICG R15,Model for End- Stage Liver Disease( MELD) score,and prothrombin time( PT) were compared between the patients with different clinical stages. According to the prognosis at 90 days,the patients were divided into survival group and death group,and the above indicators were compared between the two groups. The clinical value of ICG R15 in condition analysis and prognostic evaluation was summarized. The independent samples t- test or a one- way analysis of variance was used for continuous data,the least significant difference method was used for comparison between any two groups,and the chi- square test was used for categorical data.Results Compared with the early- stage group,the medium- stage group and late- stage group had significantly higher ICG R15( 53. 96% ±10. 01% /54. 23% ± 9. 21% vs 44. 00% ± 9. 21%,P < 0. 05),PT( 26. 87 ± 6. 84 s /28. 43 ± 3. 61 s vs 19. 79 ± 2. 82 s,P < 0. 05),and MELD score( 31. 56 ± 4. 17 /32. 87 ± 3. 28 vs 24. 00 ± 3. 85,P < 0. 05). The death group had significantly higher ICG R15,PT,and MELD score than the survival group( ICG R15: 53. 91% ± 5. 83% vs 45. 03% ± 4. 33%,t = 9. 85,P < 0. 05; PT: 29. 85 ± 3. 52 s vs 21. 35 ± 3.18 s,t = 14. 20,P < 0. 05; MELD score: 33. 81 ± 4. 67 vs 25. 30 ± 4. 02,t = 10. 99,P < 0. 05). With an ICG R15 of 52%,a PT of 29 s,and a MELD score of 32 as cut- off values,there were significant differences in mortality rate between the patients with different levels of indicators( ICG R15: 22. 39% vs 64. 29%,χ2= 8. 831,P < 0. 05; PT: 25. 71% vs 61. 40%,χ2= 6. 263,P < 0. 05; MELD score: 21. 54% vs 62. 90%,χ2= 7. 583,P < 0. 05). Conclusion With the aggravation of the condition of ACLF and the reduction in prognosis,PT and MELD score increase gradually,and ICG R15 also increases. We can comprehensively evaluate patients' condition and clinical prognosis in an early stage based on the changes in the above indicators.