原发性肝癌肝动脉化疗栓塞术后出现电解质紊乱与治疗有效率相关性分析  

Correlation of electrolyte imbalance and tumor treatment efficiency in patients with primary liver cancer after transcatheter arterial chemoembolization

作　　者：温玉蓉 张玉婷[2] 王瑞霞[1] 汪五全[1] 郭卫珍[1] WEN Yurong;ZHANG Yuting;WANG Ruixia;WANG Wuquan;GUO Weizhen(Department of Interventional Radiology,Lanzhou University Second Hospital,Lanzhou730000,China;Department of Radiology,Lanzhou University Second Hospital,Lanzhou730000,China)

机构地区：[1]兰州大学第二医院介入放射科,甘肃兰州730000 [2]兰州大学第二医院放射科,甘肃兰州730000

出　　处：《实用放射学杂志》2021年第3期471-474,518,共5页Journal of Practical Radiology

摘　　要：目的分析原发性肝癌患者首次肝动脉化疗栓塞术(TACE)后出现低钙、低磷现象与肿瘤治疗有效率的相关性。方法158例首次接受TACE治疗的原发性肝癌患者被纳入研究,根据使用栓塞材料将患者分为微球组86例(微球栓塞+化疗药)和碘油组72例(碘油栓塞+化疗药物)。采集术前、术后1 d、术后4周血清钙、磷离子浓度。使用Pearson卡方检验对比2组之间差异性。使用配对t检验对比术前与术后1 d、术后4周钙、磷离子浓度差异。根据改良实体瘤疗效评价标准(mRECIST)对比2组有效率及获益率。Kendall’s tau-b分析有效率[完全缓解(CR)+部分缓解(PR)]与术后低钙率、低磷率的相关性。结果微球组术后1 d、术后4周低钙率(46.5%、29.1%)、低磷率(50%、30.2%)高于碘油组术后1 d、术后4周低钙率(18.1%、12.5%)、低磷率(20.8%、13.9%),2组差异有统计学意义。微球组术后1 d、4周出现低钙、低磷均有统计学意义,碘油组术后1 d、4周低钙、低磷无统计学意义。微球组有效率(CR+PR,43%)、获益率[CR+PR+疾病稳定(stable disease,SD),88%]均高于碘油组有效率(CR+PR,22.2%)、获益率(CR+PR+SD,63%)。Kendall’s tau-b相关分析提示微球组有效率与术后低钙率、低磷率呈显著正相关。结论原发性肝癌患者首次TACE使用微球栓塞术后发生低钙率、低磷率及4周有效率均高于碘油栓塞。微球栓塞术后低钙率、低磷率与肿瘤治疗4周有效率呈正相关性。Objective To analyze the correlation between the incidence of low calcium and phosphorus after transcatheter arterial chemoembolization(TACE)and the efficiency of tumor treatment in patients with primary liver cancer.Methods 158 patients with primary liver cancer who underwent TACE treatment for the first time were included in the study.According to the embolization material,the patients were divided into microsphere group(86 patients,microspheres+chemotherapy drugs)and iodine oil group(72 patients,iodine oil+chemotherapy drugs).The serum calcium ion and phosphorus ion concentrations were collected before surgery,1 day and 4 weeks after surgery.Pearson chi-square test was used to compare the differences between the two groups.Paired t-test was used to compare the calcium ion and phosphorus ion concentrations before surgery,1 day and 4 weeks after surgery.According to the mRECIST criteria,the Kendall's tau-b was used to analyze the correlation between efficiency[complete response(CR)+partial response(PR)]and postoperative low calcium and phosphorus rate.Results The low calcium rate(46.5%,29.1%)and low phosphorus rate(50%,30.2%)at 1 day and 4 weeks after operation in microsphere group were higher than the low calcium rate(18.1%,12.5%)and low phosphorus rate(20.8%,13.9%)in iodine oil group,and the differences between two groups were statistically significant.There was statistical significance in low calcium and phosphorus of microsphere group 1 day and 4 weeks after operation,there was no statistical significance in low calcium and phosphorus of iodine oil group 1 day and 4 weeks after operation.The efficiency(CR+PR,43%)and benefit rate[CR+PR+stable disease(SD),88%]of microsphere group were both higher than the efficiency(CR+PR,22.2%)and benefit rate(CR+PR+SD,63%)of iodine oil group.The Kendall's tau-b correlation analysis suggested a significant positive correlation between the eficency and postoperative low calcium and phosphorus rate of microsphere group.Conclusion The incidence of low calcium,low phosphorus and

关 键 词：原发性肝癌 肝动脉化疗栓塞术 低钙 低磷 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]