Abstract

99mTc-Hepida plasma clearance test (HEP-Cl) is a specific and sensitive test of liver function, which has proved to be of much use in assessing the degree of hepatocellular damage. It can be assumed, that this test will also prove useful in monitoring the course of acute and chronic diseases of liver parenchyma and will aid in making the prognosis early in the course of the pathological process. The study was performed on 110 patients, who were divided into three groups (Group I - acute hepatitis type B, Group II - chronic active hepatitis, Group III - cirrhosis of the liver). In all patients the values of HEP-Cl were determined three times. The activity of ALT and GGTP, total bilirubin concentration, serum proteins and electrophoretic fractions were also assessed, as well as markers of infection with hepatitis B virus. The clinical condition of the patients was assessed in the beginning, and at the end of the observation period by means of physical examination. After 6 months of observation 37 patients in Group I recovered (Gr. Ia) and 7 developed chronic hepatitis type B (Gr. Ib). An increase of HEP-Cl was observed in the cases of recovery from acute hepatitis type B. In Group Ib patients exhibited a complete lack of dynamics in HEP-Cl. In the Gr. II and Gr.III effectiveness of treatment from the clinical and biochemical point of view was determined 12-18 months after the observation started. Objective examination included biochemical tests, HEP-Cl inclusive, and liverbiopsy. Youle's coefficient indicated a highly statistically significant correlation (Q=0.78) between clinical assessment and the results of HEP-Cl in chronic active hepatitis, and a lower correlation (Q=0.48) between clinical assessment and the results of HEP-Cl in cirrhosis hepatis. These data indicate that follow up by means of 99mTc-Hepida plasma clearance test is an efficient test for monitoring therapy in acute viral hepatitis type B, and chronic active hepatitis, but of less use in monitoring the course of cirrhosis of the liver.

Keywords: Cirrhosis hepatis, acute and chronic hepatitis, monitoring treatment, plasma clearance, hepida