原发性肝癌肝动脉化疗栓塞治疗间隔长短对近期肝功能影响的比较  

The impact of different intervals between two TACE procedures on the short-term liver functions in patients with hepatocellular carcinoma

作　　者：魏庭丰 何仕诚[2] 朱海东[2] 方文[2] 杜瑞杰[2] 彭博 刘琳琳 郭金和[2] 邓钢[2] 朱光宇[2] 滕皋军[2] WEI Tingfeng;HE Shicheng;ZHU Haidong;FANG Wen;DU Ruijie;PENG Bo;LIU Linlin;GUO Jinhe;DENG Gang;ZHU Guangyu;TENG Gaojun(Department of Medical Imaging,School of Medicine,Southeast University;Department of Intervention and Vascular Surgery,Affiliated Zhongda Hospital of Southeast University,Nanjing,Jiangsu Province 210009,China)

机构地区：[1]东南大学医学院影像系,南京210009 [2]东南大学附属中大医院介入与血管外科

出　　处：《介入放射学杂志》2020年第11期1126-1130,共5页Journal of Interventional Radiology

摘　　要：目的评价TACE治疗不可切除原发性肝癌2次间隔长短不同对肝功能影响程度是否有差异。方法回顾分析2013年7月至2018年12月至少连续2次TACE治疗原发性肝癌患者90例。根据TACE治疗间隔时间中位数分为A组(短间隔组间隔时间<61 d)和B组(长间隔组间隔时间≥61 d)。对比两组2次TACE前、后肝功能各项指标。结果间隔时间第1、2次TACE间隔A组平均为(48.2±7.0)d(35~60 d),B组(75.5±9.5)d(61~93 d)。2次TACE术后6 d两组ALB、TBIL、ALT、AST、CP及白蛋白-胆红素分级法(ALBI)分级分别与术前比较,差异均有统计学意义;第2次TACE前A组ALB较首次TACE前平均下降1.8 g/L,A组ALB较B组平均低2.3 g/L,差异均有统计学意义(P=0.044,P=0.046);第2次TACE前ALBI由1级降为2级的比例A组有11.4%、B组则无降级,两组比较差异有统计学意义(P=0.026);第2次TACE术后6 d A组ALB较B组平均低2.4 g/L,差异有统计学意义(P=0.033);ALBI由1级降为2级的比例A组有25.0%,B组为19.6%,两组比较差异有显著统计学意义(P=0.001)。结论原发性肝癌两次TACE后6 d肝功能均呈一过性损伤,治疗间隔延长有助于第2次TACE前的肝功能恢复更好,并减少第2次TACE后肝功能ALBI等级降低的发生。Objective To evaluate the impact of different intervals between two transcatheter arterial chemoembolization(TACE)procedures on the short-term liver functions in patients with unresectable hepatocellular carcinoma(HCC).Methods The clinical data of a total of 90 patients with unresectable HCC,who received at least two consecutive TACE treatments during the period from July 2013 to December 2018,were retrospectively analyzed.Based on the median interval between the two TACE procedures,the patients were divided into group A(short-interval group,<61 days)and group B(long-interval group,≥61 days).The preoperative and postoperative liver function indicators of twice TACE treatments were compared between the two groups.Results The mean interval between the first and second TACE in group A was(48.2±7.0)days(35-60 days),which was(75.5±9.5)days(61-93 days)in group B.Six days after the second TACE treatment,the levels of ALB,TBIL,ALT,AST,CP and the albumin-bilirubin grading(ALBI)were obviously different from the preoperative ones in both groups,the differences were statistically significant.Before the second TACE,in group A the ALB was decreased by 1.8 g/L when compared with that before the first TACE,and ALB in group A was 2.3 g/L lower than that in group B,the differences were statistically significant(P=0.044 and P=0.046 respectively).Before the second TACE,the proportion of reduction from ALBI grade-1 to ALBI grade-2 in group A and group B was 11.4%and 0%respectively,the difference was statistically significant(P=0.026).Six days after the second TACE treatment,the ALB in group A was 2.4 g/L lower than that in group B,the difference was statistically significant(P=0.033),the proportion of reduction from ALBI grade-1 to ALBI grade-2 in group A and group B was 25.0%and 19.6%respectively,the difference was statistically significant(P=0.001).Conclusion Transient liver function damage in 6 days after TACE treatment,regardless after the first or second TACE procedure,are observed in HCC patients.Prolonging treatment interv

关 键 词：肝动脉化疗栓塞术 肝功能 原发性肝癌 治疗间隔 

分 类 号：R735.7[医药卫生—肿瘤]