监测肝癌经多次肝动脉化疗栓塞术后肝损伤的新方法——肝纤维化指标的测定  

The New Method in Inspecting Liver Injure After Repeated Transcatheter Arterial Embolizationfor Treating Hepatocellular Carcinoma:The Liver Fibrotic Indicator Determined

作　　者：孔健 窦永充 许林锋[2] 梁惠明 吴汉平[3] 冯敢生[3] 

机构地区：[1]深圳市人民医院暨南大学医学院附属二院介入放射科,广东深圳518020 [2]中山医科大学附属二院介入放射科 [3]华中科技大学同济医学院附属协和医院介入放射科

出　　处：《实用放射学杂志》2002年第4期312-314,共3页Journal of Practical Radiology

摘　　要：目的　探讨原发性肝癌 (HCC)经多次肝动脉化疗栓塞术 (TAE)后肝纤维化指标的变化。方法　选择 2 0例HCC首诊患者 ,共行 3次TAE术 ,术中间隔时间为 30～ 45d ,在每次术前 2 4h测量肝纤维化 4项检测指标 :透明质酸 (HA)、层粘连蛋白 (LN)、Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (Ⅳ .C)的含量 ,并选取 2 0例健康人测量以上指标作为对照。结果　经统计学方法检验发现HCC患者肝纤维化 4项指标均较正常人明显升高 (Ρ <0 .0 5 ) ,首次TAE术后与术前 4项指标相比变化不显著 (Ρ >0 .0 5 ) ,第 2次TAE术后复查变化明显 (Ρ <0 .0 5 ) ,第 3次TAE术后复查指标变化最为显著 (Ρ <0 .0 1)。结论　反复多次进行TAE治疗HCC将加快肝纤维化的形成 ,在行TAE治疗时须严格把握手术适应证 ,术中必须强调超选择栓塞 ,术后须加强护肝治疗。Objective To investigate the change of liver fibrotic indicator in the hepatocellular carcinoma(HCC)patients after repeated transcatheter arterial infusion chemotherapy and embolization(TAE).Methods We had determined the contents of serum procollagen type-Ⅲ (PCⅢ),collagen type-Ⅳ(Ⅳ.C),hyaluronate acid(HA) and laminin(LN)of 20 patients with HCC who had received three times durations of TAE.20 normal human was served as controls.Results Remarkable significance came out in relation to the four indicators of patients and the normal (Ρ<0.05).Before and after the first duration of TAE,the four fibrotic indicators didnt rise significantly(Ρ>0.05).But compared to those before curation of TAE these indicators rose significantly(Ρ<0.05),after the second curation of TAE.Furthermord,these indicators raised more after third curation of TAE(Ρ<0.01).Conclusion The repeated curation of TAE could intensity damage of the liver.More attentions such as protect hepatic function,subsegmental embolization should be taken in and after TAE.

关 键 词：原发性肝癌 栓塞治疗 肝动脉 肝纤维化 

分 类 号：R735.7[医药卫生—肿瘤] R575.2[医药卫生—临床医学]