肝动脉碘油栓塞对肝癌并肝硬化患者血液流变指标的影响  

The Effect of Lipiodoi Embolization via Hepatic Artery on the Index of Hemorheology in the Patients with Hepatoceilular Carcinoma Accompanied with Cirrhosis

作　　者：曹玮[1] 彭建明 万毅[3] 张洪新[1] 徐哲[2] 倪代会[1] 李文献[1] 

机构地区：[1]第四军医大学唐都医院介入科,陕西西安710038 [2]第四军医大学唐都医院传染科,陕西西安710038 [3]第四军医大学卫生统计学教研室 [4]陕西省勉县医院放射科

出　　处：《实用放射学杂志》2009年第4期560-562,568,共4页Journal of Practical Radiology

基　　金：全军青年基金（01Q124）及第四军医大学科技创新工程（CX99A016）资助.

摘　　要：目的评价经肝动脉碘油栓塞（transcatheter arterial embolization，TAE）治疗，对不同肝功分级的肝癌合并肝硬化患者的血液流变指标的影响。方法50例确诊为原发性肝癌合并不同程度肝硬化患者，通过Child Pugh评分评定肝功能分级；用血液分析系统及微循环显微镜检测不同肝功能分级患者TAE前后血液流变学指标。结果TAE治疗后，Child C级全血低切黏度增加幅度（6．54±0．25）与Child B级（5．29±0．68）、Child A级（3．51±0．83）相比差异显著（P〈0．05、PG0．01），血浆黏度增加幅度（1．32±0．24）与Child B级（0．92±0．36）相比差异显著（P〈0．05），治疗后微循环加权总积分均较前增加，ChildC级微循环加权总积分增幅（4．03±0．76）与Child B级（2．74±0．21）相比差异显著（P〈0．05），与Child A级（2．29±0．54）相比差异显著（P〈0．01）。结论碘油栓塞可加重肝癌合并肝硬化患者微循环障碍，其影响程度与肝功能分级正相关。Objective To evaluate the effect of transcather arterial lipiodol embolization on the index of hemorheology in the patients with hepatocellular carcinoma （HCC） accompanied with cirrhosis in different level of liver function. Methods 50 patients with HCC accompanied with cirrhosis received lipiodol embolization via hepatic artery. Baseline liver function was evaluated with ChildPugh scores,the indexes of hemorheology were tested with blood analysis system and microcirculation microscope before and 3th day after lipiodol embolization therapy in all cases. Results After the therapy, the amplification of whole blood low-shearing viscosity in Child C（ 6.54±0.25 ） was higher than that in Child B（ 5.29 ±0.68） and Child A（ 3.51 ± 0.83） （P〈0.05 and P〈0.01, respectively）, the amplification of plasma viscosity in Child C （1.32 ± 0.24） was higher than that in Child A（ 0.92±0. 361 （P〈0.05）. Tianniu weighted integrals in all degree of hepatic function were all increased after therapy than before, the integral amplification in Child C（4.03±0.76）was higher than that in Child B（2.74±0.21）and Child A（2. 29±0. 54） （P〈0.05 and P〈0.01,respectively）. Conclusion Lipiodol embolization via hepatic artery may aggravate the microcirculation state in the patients with HCC accompanied with cirrhosis, the degree of damage is positive correlation with the level of the patient＇s hepatic function of patient.

关 键 词：肝脏 肝癌 肝功能 血液流变学 介入放射学 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]