动脉血酮体比及血清Ⅳ型胶原检测在肝癌病人手术治疗中的临床意义  

Clinical significance of determination of AKBR and serum collagen type Ⅳ in patients treated with operation for hepatoma.

作　　者：冉江华[1] 杨炯[1] 张家骅[1] 郭群[1] 沈浩 陆晓青[1] 

机构地区：[1]昆明医学院第二附属医院肝胆外科,昆明市650101

出　　处：《中华肝胆外科杂志》2000年第1期13-14,共2页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　探讨测定动脉血酮体比 (AKBR)和血清Ⅳ型胶原 (Ⅳ C)在肝癌病人手术及预后评估中的意义。方法　在手术前后对 2 0例行部分肝切除的原发性肝癌病人连续测定AKBR和血清Ⅳ C并与术后并发症发生情况作对比。结果　按术后AKBR分成 3组 ,A组 (10例 ) :始终≥ 0 7;B组(7例 ) :波动在 0 4和 0 7之间 ;C组 (3例 ) :降在 0 4之下。各组并发症发生率依次为 2 0 % ,4 3 % ,和10 0 %。按术后Ⅳ C分为两组 :<2 0 0 μg L的Ⅰ组中A ,B ,C各有 8例 (72 7% ) ,3例 (2 7 3 % )和 0例 ;≥2 0 0 μg L的Ⅱ组中A ,B ,C各有 2例 (2 2 2 % ) ,4例 (4 4 4% )和 3例 (3 3 3 % )。两组构成比差异有显著意义 (P <0 0 5)。结论　术后连续测定AKBR和Ⅳ C有助于判断病人肝功能储备 ,指导治疗和评价预后。Objective To evaluate the significance of determining arterial blood ketone body ratio ( AKBR ) and collagen type Ⅳ (Ⅳ C) in patients treated with operation for hepatoma. Methods Before and after partial hepatectomy, 20 patients with hepatoma were continuously studied for their AKBR and Ⅳ C and compared with postoperative complications. Results Patients were classified into three groups according to the value of AKBR : group A(10 cases), always above 0.7; group B (7 cases), maintaining between 0.4 and 0.7; group C(3 cases), below 0.4. Their complication incidence was 20%, 42.9%, 100%, respectively. The patients were also divided into two groups by serum collagen Ⅳ C after operation: Ⅰ remained higher than 200 μg/L and Ⅱ decreased down below 200 μg/L. There were 8 cases of A (72.7%), 3 cases of B (27.3%), and 0 cases of C in group Ⅰ; as to group Ⅱ there were 2 cases of A (22.2%),4 of B (44.4%),and 3 of C(33.3%). The proportion between the two groups was significantly different. Conclusions AKBR and serum collagen Ⅳ C are helpful indicators to assess hepatic energetic reserve and postoperative prognosis.

关 键 词：肝细胞肿瘤 动脉血酮体比 Ⅳ型胶原 

分 类 号：R730.56[医药卫生—肿瘤]