肝动脉化疗栓塞术治疗原发性肝癌后肝纤维化指标的改变  

The related to the fibrotic indicators of primary hepatocellular carcinoma patients after transcatheter arterial chemoembolization.

作　　者：孔健[1] 窦永充 许林锋[1] 梁惠明[1] 吴汉平[1] 冯敢生[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院介入放射科,武汉市430020

出　　处：《中华肝胆外科杂志》2002年第7期414-416,共3页Chinese Journal of Hepatobiliary Surgery

基　　金：卫生部科研基金资助 (合同号 :98 1 13 2 )

摘　　要：目的　探讨肝癌 (HCC)经多次肝动脉化疗栓塞术 (TACE)后是否加快肝纤维化的发展趋势。方法　选择 2 0例原发性肝癌 (HCC)首诊病人 ,共行 3次TACE术 ,手术间隔时间为 1个月 ,定期测量肝纤维化 4项指标 :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　经统计检验发现HCC病人肝纤维化 4项指标较正常人明显升高 (P <0 0 5 ) ,TACE术后 4项指标呈进行性增高 ,第 2次TACE术后 1个月复查变化明显 (P <0 0 5 ) ,第 3次TACE术后复查指标变化最为显著 (P <0 0 1)。结论　重复进行TACE治疗HCC将加快肝纤维化发展趋势 ,在行TACE治疗时须严格把握适应证。Objective To determine whether transcatheter arterial chemoembolization (TACE) can aggravate the formation of hepatic fibrosis in patients with primary hepatocellular carcinoma (HCC). Methods We 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 cycles of TACE. Twenty normal individuals were employed to serve as the controls. Results Four indicators of hepatic fibrosis were significantly increased in patients with HCC as compared with the normal controls (P<0 05). Before and after the first duration of TACE, the four fibrotic indicators did not markedly rise. However, these indicators remarkably rose (P<0 05) after the second duration of TACE as compared with those before TACE. Furthermore, significant increase of these indicators was found after the third duration of TACE (P<0 01). Conclusions The repeated duration of TACE will intensify the liver damage. More attention should be paid to protecting hepatic function and preventing liver fibrosis after TACE.

关 键 词：肝动脉化疗栓塞术 治疗 原发性肝癌 肝纤维化 

分 类 号：R735.7[医药卫生—肿瘤] R730.53[医药卫生—临床医学]