肝硬化CT分级评估肝癌介入治疗肝储备功能及预后研究  

Hepatic Functional Reserve and Prognosis after Liver Interventional Therapy:Evaluation by CT Grading of Liver Cirrhosis

作　　者：韦勇[1] 涂蓉[1] 陈忠明[1] 纪昌学[1] 何冬雷[1] 邓丹琼[1] 陈又珍[1] 万江花[1] 

机构地区：[1]海南医学院附属医院放射科,海口570102

出　　处：《临床放射学杂志》2010年第12期1671-1674,共4页Journal of Clinical Radiology

基　　金：海南省自然科学基金资助项目(编号:30122)

摘　　要：目的探讨肝硬化CT分级评估肝癌介入治疗肝储备功能及预后的价值。资料与方法前瞻性研究60例原发性肝癌患者行肝动脉化疗栓塞术(TACE)的资料。所有患者均行肝脏双期增强CT扫描。术前行肝硬化CT分级,并与术后肝功能生化指标变化及生存时间等指标进行对照研究。结果 CT分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级的中位生存时间分别为53个月、14个月、5个月和2个月,Ⅰ级和Ⅱ级合并组与Ⅲ级和Ⅳ级之间有显著差异,经log-rank检验,3条生存曲线之间差异有统计学意义(χ2=54.786,P<0.000),两两之间差异均有统计学意义;术前、术后谷草转氨酶(AST)和谷丙转氨酶(ALT)的变化率各CT分级之间差异有统计学意义;用生存分析法进行多变量Cox回归分析,发现导管位置和CT分级与生存时间关系最密切,且CT分级各组间差异有统计学意义(P<0.05)。结论肝硬化CT分级越高,生存时间越短,硬化CT分级在介入手术前对评估肝脏储备功能和预后有一定价值。Objective To assess the hepatic functional reserve and prognosis after the Liver interventional therapy using CT grading of liver cirrhosis.Materials and Methods Sixty patients with primary liver cancer underwent liver dual phase enhanced CT scan.CT grading of liver cirrhosis before TACE treatment were compared with biochemical markers of liver function and survival time after TACE treatment.Results According to the liver CT grading of 1,2,3 and 4 grades,the median survival time was 53 months,14 months,5 months and 2 months respectively.There was significant difference of survival curve among grade 3,grade 4 and the grade 1 combine with grade 2（χ2=54.786,P0.000）.Compared the values before and after TACE treatment,AST and ALT had significant difference among CT grading groups.The location of catheter and CT grading were the main factors which had close correlation with survival time.Conclusion The higher CT grading of liver cirrhosis,the shorter the survival time is.Liver cirrhosis CT grading has value of evaluating liver functional reserve and prognosis before TACE treatment.

关 键 词：肝癌 肝储备功能 介入治疗 肝硬化分级 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]