中晚期肝癌患者肝动脉化疗栓塞术后肝功能代偿不全影响因素分析被引量：11

Multivariate analysis of liver function reserve after transcatheter arterial chemoembolization in patients with advanced liver cancer

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摘要目的:分析中晚期原发性肝癌(HCC)首次行肝动脉化疗栓塞术(TACE)后出现肝功能代偿不全的影响因素。方法:回顾性分析103例中晚期HCC首次行TACE术患者的临床资料,根据其术后是否发生肝功能代偿不全分为2组,对2组患者术前、术后相关临床数据进行单因素与多因素分析,找出影响患者术后出现肝功能代偿不全的主要因素。结果:单因素分析显示,术前患者吸烟、年龄、门脉Ⅱ级主干癌栓、乙肝、凝血酶原时间、D-二聚体、谷氨酰转肽酶(GGT)水平、肿瘤大小均是首次TACE术后出现肝功能代偿不全的影响因素(均P<0.05);多因素logistic回归分析显示,年龄、血凝血酶原时间、D-二聚体、GGT、肿瘤大小是首次TACE术后出现肝功能代偿不全的危险因素(均P<0.05)。结论:高龄、肿瘤较大、凝血酶原时间、D-二聚体、GGT升高的中晚期HCC患者行TACE术后出现肝功能代偿不全的风险高。 Objective:To analyze the influencing factors of compensatory insufficiency of liver function in patients with advanced primary hepatocellular carcinoma(HCC)for the first time after transcatheter arterial chemoembolization(TACE).Methods:A total of 103 patients with primary advanced HCC who underwent TACE for treatment were reviewed,and divided into two arms according to whether insufficiency of liver function was developed after TACE.Univariate and multivariate analyses were performed on the clinical data before and after TACE to screen the main factors influencing postoperative insufficiency of liver function.Results:Univariate analysis showed that smoking,age,main portal vein(TpyeⅡ)tumor thrombus,hepatitis B infection status,prothrombin time,D-dimer,GGT level and main tumor size before TACE were the influencing factors of compensatory insufficiency of liver function after the first time of TACE(P<0.05).Multivariate logistic regression analysis showed that age,prothrombin time,D-dimer and GGT and tumor size were the influencing factors of compensatory insufficiency of liver function after the first time of TACE(P<0.05).Conclusion:Advanced age,larger tumor size,prothrombin time,D-dimer and elevated GGT increased the risk of compensatory insufficiency of liver function in patients with advanced HCC after TACE.

作者赵淑芬刘卓环黄江远罗美华周成宇 ZHAO Shu-fen;LIU Zhuo-huan;HUANG Jiang-yuan;LUO Mei-hua;ZHOU Cheng-yu(Shunde Hospital of Southern Medical University (First Peopled Hospital of Shunde District),Foshan 528300,China)

机构地区南方医科大学顺德医院(佛山市顺德区第一人民医院)

出处《内科急危重症杂志》 2019年第1期19-20,82,共3页 Journal of Critical Care In Internal Medicine

基金佛山市自筹经费类科技计划项目(No:2016AB003473) 佛山市十三五高水平重点专科建设项目

关键词原发性肝癌经肝动脉化疗栓塞中晚期肝癌肝功能储备肝功能代偿不全 Primary liver cancer Hepatocellular carcinoma Transcatheter arterial chemoembolization Advanced liver cancer Liver function reserve Liver function compensatory insufficiency

分类号 R753.7 [医药卫生—皮肤病学与性病学]

作者简介通信作者:罗美华,E-mail:lizihua998@163.com.

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参考文献4

1崔艳峰,祖茂衡,徐浩,顾玉明,李国均,张庆桥,魏宁.肝细胞癌TACE术后严重并发症分析[J].中国介入影像与治疗学,2005,2(1):31-33. 被引量：34
2原发性肝癌诊疗规范（2011年版）摘要[J].中华肝脏病杂志,2012,20(6):419-426. 被引量：232
3周霖,王华明,艾鼎伦,赵云,张林枝,余强,杨斌,彭晓明,王京艳,刘春梓.原发性肝癌患者肝动脉化疗栓塞术后肝功能失代偿的临床分析[J].解放军医学杂志,2014,39(2):149-153. 被引量：34
4元淑巧,杨银芳,胥敏敏,李燕平,张立文.血浆D-二聚体及纤维蛋白(原)降解产物检测的临床意义[J].解放军医学院学报,2014,35(9):896-898. 被引量：37

二级参考文献33

1向昕,刘志伟,史宪杰,顾万清.经导管肝动脉化疗栓塞后肝癌微血管密度及血管内皮生长因子的表达[J].解放军医学杂志,2005,30(1):45-45. 被引量：8
2陈晓明,罗鹏飞.肝癌经导管肝动脉化疗性栓塞存在的问题与对策[J].实用医学杂志,2007,23(6):786-787. 被引量：14
3许文荣,王建中.临床血液学检验[M].5版.北京:人民卫生出版社,2012:86.
4El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma[J]. Gastroenterology, 2012, 142 (6): 1264-1273.
5Said A, Wells J. Management of hepatocellular carcinoma[J]. Minerva Med, 2009, 100 ( 1 ): 51-68.
6Llovet JM, Real MI, Montafia X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial[J]. Lancet, 2002, 359(9319): 1734-1739.
7European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(6): 908-943.
8Grieco A, Pompili M, Gaminiti G, et al. Prognostic factors for survival in patients with early-intermediate hepatocellular carcinoma undergoing non-surgical therapy: comparision of Okuda, CLIP, and BCLC staging systems in a single Italian centre[J]. Gut, 2005, 54:411-418.
9Santarpia L, Grandone I, Contaldo F. Butyrylcholinesterase as a prognostic marker: a review of the literature[J]. J Cachexia Sarcopenia Muscle, 2013, 4(1): 31-39.
10Yoshiba M, Sekiyama K, Inoue K, et al. Accurate prediction of fulminant hepatic failure in severe acute viral hepatitis: multicenter study[J]. J Gastroenterol, 2002, 37(11): 916-921.