血小板计数与肝细胞癌根治性切除术后肝功能恢复相关性研究

Correlation study between platelet count and liver function recovery of hepatocellular carcinoma after curative resection

目的:研究血小板计数与肝细胞癌根治性切除术后肝功能恢复的相关性,分析其在预测肝功能衰竭中的价值。方法:收集根治性肝切除的肝癌患者95例,检测其血小板计数以及谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(TB)水平,按照血小板计数的不同,分为低血小板组和正常血小板组,分析两组肝功能及术后肝功能衰竭的危险因素。结果:95例肝癌患者采用根治性肝切除治疗后第1天发生低血小板计数(<100×109/L)33例(34.7%),血小板正常者62例(65.3%)。低血小板组与正常血小板组术前ALT、AST、GGT、ALP和TB比较,差异无统计学意义(P>0.05)。两组术后3周ALT、AST、GGT、ALP和TB水平均较术前明显下降(P<0.05),正常血小板组治疗后ALT、AST、GGT、ALP和TB水平均低于同期低血小板组,差异有统计学意义(P<0.05)。单因素Logistic回归分析,根治性肝切除治疗后发生肝功能衰竭的危险因素为TB和血小板计数(OR=2.98,95%CI 1.12~4.59,P=0.031;OR=4.15,95%CI 1.24~5.38,P=0.006)。结论:肝癌患者采用根治性肝切除术后血小板计数与肝功能恢复密切相关,可作为术后发生肝功能衰竭的危险指标。

Objective：To study the correlation between platelet count and liver function recovery of hepatocel-lular carcinoma after curative resection. Methods： Platelet count, and alanine aminotransferase （ALT） , aspartate aminotransferase （AST） , glutamyl peptidase （GGT） , alkaline phosphatase （ALP） , total bilirubin （TB） were detec-ted in 95 cases with hepatocellular carcinoma patients after curative resection. According to the difference of the platelet count, the two groups were divided into low platelet group and normal group. The risk factors of liver func-tion and liver function failure after operation were analyzed. Results： Among 95 cases patients of hepatocellular carci-noma treated with curative liver resection after the first day, low platelet count was 33 cases,accounting for 34. 7% and platelets normal was 62 cases,accounting for 65. 3%. There were no significant differences in ALT, AST, GGT,ALP and TB between low platelet count group and normal platelet count group（P〉0. 05）. After operation 3 weeks, ALT, AST, GGT, ALP and TB were significantly degraded（P〈0. 0 5 ）, and the levels of this stage in low platelet count group were significantly lower than those in normal platelet count group（P〈0 . 05）. Univariate logistic regression analysis showed TB and platelet count were risk factors for hepatectomy liver failure after radical treat- ment（OR=2. 98, 95%CI1. 12-4. 59, P = 0. 031; OR=4. 15, 95%CI1.24-5. 38, P=0 . 006）. Concluskm：Plate- let count is closely related with liver function recovery in hepatocellular carcinoma patients after curative resection, which can be as a postoperative liver failure risk indicator, providing the basis for clinical treatment.