超声引导无水酒精注射术对肝癌患者乙醇代谢酶活性影响的临床研究

The Impact of ultrasound-guided percutaneous ethanol injection on ethanol metabolic enzymatic activity for patients with primary liver cancer-a clinical research

目的:探讨超声引导无水酒精注射(PEI)治疗对原发性肝癌患者乙醇代谢酶活性的影响。方法:原发性肝癌行PEI治疗30例为治疗组,以同期门诊体检30例健康成人为对照组,比较治疗前治疗组转氨酶及乙醇代谢酶水平与对照组的差异,观察比较PEI治疗前及治疗3、6、8次后转氨酶和乙醇代谢酶的变化。结果:治疗组PEI治疗前转氨酶及乙醇代谢酶活性明显高于对照组(P<0.001);治疗组治疗3、6、8次后均显著高于治疗前(P<0.001);第3次治疗后升高最明显,第6次后逐渐趋缓,第8次后下降但仍高于术前,两两比较有显著性差异(P<0.001)。结论:原发性肝癌患者PEI治疗前就存在一定程度肝细胞损害,PEI治疗可造成癌旁肝细胞损害,致患者血清乙醇代谢酶活性升高,多次PEI治疗并未无限度地加重肝损害。检测乙醇代谢酶活性可作为临床评价PEI对癌旁肝组织损害程度的指标。

Objective：To evaluate the effect of ultrasound-guided percutaneous ethanol injection（PEI） on ethanol metabolic enzymatic activity for patients with primary liver cancer（PLC）.Methods：30 patients with PLC who underwent PEI were in treatment group.30 healthy individual outpatients were used as control groups at the corresponding period.Before treatment,the transaminase and ethanol metabolic enzyme of all participants in two groups were compared.We observed and compared the changes of patients＇ transaminase and ethanol metabolic enzyme before and after the third,the sixth and the eighth PEI treatment.Results：Patients before PEI treatment showed statistically significant higher serum transaminase and ethanol metabolic enzymatic activity than patients in control group（P0.001）,lower than after the third,the sixth and the eighth PEI treatment（P0.001）.The serum concentration of transaminase and ethanol metabolic enzymatic activity reached peak value after the third,degraded gradually after the sixth and descended after the eighth PEI treatment.Conclusion：Some of the hepatocytes of patients with PLC are injured before PEI treatment.PEI treatment may damage the peficancerous tissues,consequent on rising ethanol metabolic enzymatic activity.Nevertheless,it is appreciate that PEI treatments do not damage the liver function indefinitely.The ethanol metabolic enzymatic activity may be an indicator for evaluating the extent of damage of PEI treatment for normal liver tissues.