肝动脉化疗栓塞术对原发性肝癌患者肝肾功能及血常规的影响  

Effect of transcatheter arterial chemoembolization on liver and kidney function and blood routine in patients with primary liver cancer

作　　者：周宇杰[1] 徐细明[1] 梁慧玲[1] 陈嘉羽[1] 

机构地区：[1]武汉大学人民医院肿瘤科,武汉430060

出　　处：《临床与病理杂志》2017年第11期2407-2415,共9页Journal of Clinical and Pathological Research

基　　金：湖北省自然科学基金(2012FKC14301)~~

摘　　要：目的:探讨肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)对原发性肝癌患者肝肾功能及血常规的影响。方法:收集57例接受TACE治疗的原发性肝癌患者的临床资料,比较患者术前术后的肝肾功能及血常规指标的差异,并分析TACE术后肝功能损伤的相关因素。结果:TACE治疗后第1天ALT和AST显著升高,血清总蛋白(total protein,TP)和血清白蛋白(albumin,ALB)从术后第1天到术后第1周逐渐降低,总胆红素(total bi lirubin,TBi l)和直接胆红素(direct bi lirubin,DBi l)在术后第3天较术后第1天、术后第7天均高,差异均具有统计学意义(P<0.05)。术后第1天的血尿素水平较术前升高,差异有统计学意义(P<0.05)。WBC计数在术后第1天显著升高,差异均有统计学意义(P<0.05)。TACE术后肝功能损伤与患者术前WBC计数和PLT计数、术前TP和ALB、术前TBil、术前肝功能Child-Pugh分级以及门脉癌栓呈显著性相关(P<0.05)。结论:TACE可引起原发性肝癌患者肝功能损伤和肾功能一过性损害以及WBC计数一过性升高,并且术前WBC和PLT计数低、TP和ALB低、TBil高、肝功能Child-Pugh分级为B级,且合并门脉癌栓的原发性肝癌患者更容易发生TACE术后的肝功能损伤。Objective： To investigate the effect of transcatheter arterial chemoembolization（TACE） on liver and kidney function and blood routine in patients with primary liver cancer. Methods： Clinical data of 57 patients with primary hepatocellular carcinoma treated with TACE were collected. The differences of liver and kidney function and blood routine indexes were compared between the same patients before and after operation. And the related factors of liver function injury after TACE were analyzed. Results： The levels of alanine aminotransferase and aspartate aminotransferase were significantly increased at the 1 st day after TACE treatment. Serum total protein（TP） and serum albumin（ALB） decreased gradually from the 1 st day to the 1 st week after operation. Total bilirubin and direct bilirubin（DBil） were higher on the third day after operation than on the 1 st and 7 th day. Differences were statistically significant（P〈0.05）. The white blood cell count was significantly increased on the 1 st day after operation and the difference was statistically significant（P〈0.05）. There were significant correlations between liver function injury after TACE and preoperative white blood cell count, platelet count, preoperative total protein, preoperative albumin, preoperative total bilirubin, preoperative liver function Child-Pugh grade and portal vein thrombosis（P〈0.05）. Conclusion： TACE can cause liver injury, transient impairment of renal function and a transient increase in white blood cell count in patients with primary liver cancer. Primary liver cancer patients who have low preoperative white blood cell count and platelet count, low preoperative total protein and preoperative albumin, high preoperative total bilirubin and whose preoperative liver function Child-Pugh grade is B grade and who is combined with portal vein tumor thrombus are more likely to occur liver injury after TACE.

关 键 词：原发性肝癌 肝动脉化疗栓塞术 肝功能 

分 类 号：R735.7[医药卫生—肿瘤]