还原型谷胱甘肽对原发性肝癌患者经射频消融术后肝损害作用的研究

Effect Observation of Atomolan in the Treatment of Liver Injury in Patients with Primary Hepatic Carcinoma after Radiofrequency Ablation

目的:观察还原型谷胱甘肽对原发性肝癌患者经射频消融术(RFA)术后肝损害的疗效及安全性。方法:选择肝功能Child-Pugh分级正常、准备行RFA的原发性肝癌患者76例,随机分为治疗组与对照组,各38例。对照组用肌苷、维生素C等常规护肝药物治疗;治疗组在肌苷、维生素C等常规护肝药的基础上,加用还原型谷胱甘肽(1.8g加入5%葡萄糖注射液250mL)。2组均在RFA术前3天用药,静脉滴注,每日1次,连用3d;术后当天开始用药,静脉滴注,每日1次,连用7d。分别于RFA术后第1天、第7天、第15天测定血总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总蛋白(SP)、白蛋白(A)、血小板(PLT)、凝血酶原时间(PT);记录RFA术后不良反应的发生率。结果:RFA术后2组肝功能均有异常,但治疗组术后第15天TBIL、ALT和AST明显低于对照组(P<0.01),SP、A比较差异无统计学意义(P>0.05)。结论:还原型谷胱甘肽对原发性肝癌患者RFA术后肝损害有显著的保护作用,可减轻RFA副反应。

OBJECTIVE： To observe the therapeutic efficacy and safety of atomolam in the treatment of liver injury in primary hepatic carcinoma patients after radiofrequency ablation （RFA）. METHODS： 76 primary hepatic carcinoma patients with normal liv- er function undergoing RFA were randomly divided into treatment group and control group with 38 patients in each group. Control group was given camine, vitamin C and other drugs for liver-protective treatment： treatment group was additionally given atomol- am 1.8 g added into 5% glucose injection 250 mL on the basis of control group. 2 groups were given medicine 3 days before RFA, i.v. gtt, once a day for consecutive 3 days： they were given medicine on same day of operation, i.v. gtt, once a day for consecu- tive 7 days. The liver function markers （serum levels of TBIL, ALT, AST, SP, A, PLT and PT） of 2 groups were detected and compared in 1 day, 7 days and 15 days after RFA respectively. The incidences of adverse drug reactions after RFA were recorded. RESULTS： After RFA, the liver function became abnormal gradually in both 2 groups, but the serum levels of ALT, AST and TBIL ~n treatment group were lower than control group significantly in 15 days after RFA （P〈0.01）, while there was no signifi- cant difference in levels of SP and A （P〉0.05）. CONCLUSION： Atomolan has some protective effect on liver function in primary hepatic carcinoma patients, and relieves some side effect induced by RFA.