HITT与TACE术对肝细胞癌患者肝功能影响的比较

Comparison of liver function test changes after high-frequency induced thermotherepy and transcatheter-arterial chernoembolization treatment in patients with hepatocellular carcinoma

目的比较高频介导热治疗(HITT)与经导管肝动脉化疗栓塞术(TACE)治疗肝细胞癌患者对肝功能的影响。方法将98例原发性肝癌(PHC)患者随机分为两组,分别行HITT和TACE术,术前、术后3d、2wk、4wk分别行肝功能检查,比较总胆红素(TBIL)、白蛋白(ALB)、谷丙转氨酶(ALB)、及凝血酶原活动度(PTA)的变化情况。结果两组术前各指标均无显著差异(t值分别为1.224-、0.678-、1.268-1、.045,p均>0.05)。HITT术后3d患者血清TBIL和ALT与术前比较有显著升高,PTA显著下降(t值分别为-3.355-、2.017、2.893,P均<0.05);HITT术后2wk除PTA有显著下降(t=2.581、P<0.05)外,TBIL、ALB、ALT已恢复至术前水平(t值分别为-1.730-、0.155、1.219,P均>0.05);HITT术后30d各指标与术前比较均无显著差异(t值分别为-1.571-、0.698、0.113、0.557,P均>0.05)。TACE术后3d、2wk患者TBIL、ALT与术前比较有显著升高,ALB明显下降(3d t值分别为-2.397-2、.895、2.366,P均<0.05;2wk t值分别为-1.923、3.827-、3.166,P均<0.05),而PTA与术前比较无显著变化;TACE术后30d各指标与术前比较均无显著差异(t值为-1.388、1.679-、1.100、0.666,P均>0.05)。结论PHC患者选择HITT或TACE术治疗均可引起短暂的一过性肝功能损害,但HITT术引起的肝脏炎症反应相对较轻,持续时间短,但两种治疗方案均较安全,都不会导致持久和严重的肝功能损害。

Objective To compare the influence on liver function tests after high-frequency induced thermotherepy （HITT） and transcatheter arterial chemoembolization （TACE） in patients with hepatocellular carcinoma （HCC）. Methods 98 patients with HCC were randomly divided into two groups to receive HITT or TACE, respectively. Liver function tests were evaluated 3 days,2 weeks,and 4 weeks after the procedures. Results There was no significant difference between two groups in all baseline parameters （TBIL,ALB, ALT, PTA, t= 1. 224,-0. 678,-1. 268,-1. 045, respectively, P 〉0. 05）. TBIL and ALT increased significantly 3 days after HITT, while PTA decreased significantly （t=-3. 355, -2. 017,2. 893 respectively,P〈0. 05）. The difference between the baseline parameters （TBIL, ABL, ALT） and those 2 weeks after HITT Was no significant （t=-0. 173,-0. 155,1. 219 respectively, P〉0. 05）, while PTA was significantly decreased （ t = 2.581, P〈0. 05）. And no significant difference was exhibited between all baseline parameters （TBIL, ALB, ALT, PTA） and those 30 days after HITT （t=-1. 571,-0. 698,0. 113,0. 557, respectively, P〉0. 05）. In patients received TACE,the parameters （TBIL, ALT） 3 days and 2 weeks after the procedure were significantly increased compared to baseline parameters, while ALB was significantly decreased （t=-2. 397,-2. 895,2. 366,respectively 3 days after TACE, P 〈0. 05; t=-1. 923,3. 827,-3. 166 respectively 2 weeks after TACE, P〈0. 05）, and there was no significant difference in PTA. No parameters 30 days after TACE had significant difference compared to baseline parameters. Conclusion Transient impairment to liver function can be induced by both HITT and TACE in patients with HCC. However, both HITT and TACE are safe, and no lasting, serious worsening of liver function can be caused.