肝癌患者血清HBV-DNA水平及血清肝酶学水平与术后并发症的关系研究  

The Analysis of the Dynamic Change of ALT,AST and GGT in Hepatocarcinoma Patients After Hepatectomy with Expressions of HBV-DNA

作　　者：孙峰[1] 刘继斌[1] 

机构地区：[1]南通大学附属肿瘤医院,江苏南通226361

出　　处：《肿瘤基础与临床》2008年第6期469-471,共3页journal of basic and clinical oncology

摘　　要：目的研究HBV-DNA阳性原发性肝癌患者血清HBV-DNA水平与血清肝酶学水平变化对并发症发生的评估与防治的关系,以期寻找简便指标预测并发症的发生,指导临床实践。方法1998—2005年南通大学附属肿瘤医院收治HBV-DNA阳性HCC肝切除术60例,HBV-DNA阴性HCC肝切除术36例。所有病例进行肝功能评估,分别于术前、术后1 d、7 d、14 d测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT),PCR法检测HBV-DNA。生化指标均在日立7170A全自动生化分析仪测定。结果并发症组HBV-DNA阳性肝切除术患者与HBV-DNA阴性肝切除术患者血清ALT、AST、GGT水平显著增高(P<0.05),而无并发症组HBV-DNA阳性肝切除术术患者与HBV-DNA阴性肝切除术患者血清ALT水平无显著差异。不同血清HBV-DNA水平组间肝切除术后ALT、AST、GGT峰值均有显著性差异,HBV-DNA水平越高ALT、AST、GGT峰值亦越高(2χ=6.578,P<0.05)。不同血清HBV-DNA水平组间肝切除术后肝功能恢复时间有显著性差异,HBV-DNA水平越高肝功能恢复时间越长(2χ=11.32,P<0.05)。结论术前血清HBV-DNA高水平将影响术后肝功能恢复,而肝功能敏感指标则为相应的血清肝酶学水平的变化,手术前后动态监测肝癌患者血清HBV-DNA水平与血清肝酶学水平对预测病情发展尤其是并发症的发生有一定的临床价值。Objective To study the relationship between the expression levels of the HBV-DNA and the dynamic changes of ALT, AST and GGT in hepatocarcinoma patients after hepatectomy to probe an index so as to predict complications. Methods From 1998 to 2005, there were 60 cases hepatectomied with HBV-DNA positive and 36 cases done with HBV-DNA negative in Nantong tumor hospital. The liver function of all the cases was evaluated. The preoperative and one week postoperative serum ALT, AST and GGT levels were measured by Hitachi 7170A completely automatic biochemistry analyzer. HBV-DNA was measured by PCR. Results After hepatectomy, ALT, AST and GGT levels were obvious ascension. Later dropped close the preoperative level in HBV-DNA positive group, as well as HBV-DNA negative group. There was significant difference（P 〈 0.05） between complication group and non-complication group. There were significant difference（ P 〈 0.05） between complication group with HBV-DNA positive and that with HBV-DNA negative. But the non-complication group was on the contrary. The serum HBV-DNA level in preoperation was not significantly different with that in postoperation. The preoperative serum HBV- DNA level was significantly positive correlated with the peak value of serum HBV-DNA level and the recovery period of liver function after hepatectomy. Conclusion High level of serum HBV-DNA would result in the aggravation of hepatic dysfunction and the extend of liver function recovery. Detection of the levels of serum hepaticenzyme and serum HBV-DNA can predict the incidence of complication after hepatectomy.

关 键 词：HBV—DNA阳性 肝癌 ALT 术后 

分 类 号：R730.43[医药卫生—肿瘤] R735.7[医药卫生—临床医学]