抗病毒治疗对肝癌患者围手术期胰岛素抵抗的改善作用

Improvement of perioperative insulin resistance in patients with hepatectomy combined with anti-viral therapy

目的:探讨抗病毒治疗对肝癌患者围手术期胰岛素抵抗的改善作用。方法:110例肝癌切除术患者随机分为治疗组(60例)及对照组(50例),检测两组患者围手术期空腹血糖(fasting plasma glucose,FPG)、血清胰岛素水平(fasting serum insulin,FINS)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)并计算胰岛素抵抗指数(hemeostasis model assement of insulin resistance,HOMA-IR),观察两组胰岛素抵抗变化情况。结果:两组患者术后血清IL-6、TNF-α水平均较术前升高,但治疗组升高幅度低于对照组,两组比较有统计学差异(P<0.05)。两组患者术前存在有不同程度胰岛素抵抗,术后胰岛素抵抗水平较术前加剧,但治疗组患者术后胰岛素抵抗情况及术后并发症发生率较对照组改善,两组比较有统计学差异(P<0.05)。结论:抗病毒治疗可改善肝癌切除术患者围手术期胰岛素抵抗。

Objective：To investigate the improvement of the perioperational insulin resistance of people underwent hepatectomy combined with anti - viral treatment. Methods：110 patients were randomly divided into treatment group （60 cases）and control group（50 cases）according to the anti - viral treatment（Entecavir,0. 5mg/ d）. The data of FPG,FINS,IL - 6 and TNF - α were measured perioperationally,and HOMA - IR was calculated to eveluate the insulin resistance changes. Results：The postoperational serum level of IL - 6,TNF - α were significantly elevated in both groups,and the treatment group had a significant smaller evluated range compared with the control group（P 〈 0. 05）. Patients in both groups presence insulin resistance before operation,the postoperational data of FPG,FINS and HOMA- IR were increased in both groups,but the insulin resistance level and the complication rates of treatmen group were significantly improved than the control group（P 〈 0. 05）. Conclusion：Anti - viral therapy may improve perioperative insulin resistance in patients with hepatectomy.