乙肝相关性肝癌患者术前HBV-DNA载量水平与术后肝功能恢复的关系分析

Relationship between preoperative HBV-DNA load and postoperative liver function recovery in patients with hepatitis B related hepatocellular carcinoma

目的探讨乙肝相关性肝癌(HCC)患者术前HBV-DNA载量水平与术后肝功能恢复的关系。方法将56例行肝癌根治术的HCC患者按术前血清中HBV-DNA载量分为低复制组(血清HBV-DNA载量≤104IU/ml,n=35)和高复制组(血清HBV-DNA载量≥105IU/ml,n=21),观察比较术前3 d和术后7 d HBV-DNA载量变化例数及ALT、AST、ALB、TBIL等肝功能指标变化、肝功能恢复时间,同时记录两组患术后并发症发生情况。结果两组患者手术前、后血清中HBV-DNA载量无显著性变化(P>0.05),两组患者术后7 d ALT、AST、TBIL指标较术前3 d显著升高(P<0.05),而三组术后ALB指标较治疗前显著降低(P<0.05),且高复制组ALT、AST指标显著高于低复制组(P<0.05),而两组在ALB和ABIL等指标比较,差异不具有统计学意义(P>0.05)。而低复制组肝功能恢复天数显著短于高复制组,差异具有统计学意义(P<0.05)。高复制组患者术后并发症(47.62%)显著高于低复制组患者(17.14%),差异具有统计学意义(P<0.05)。结论 HCC患者术前血清HBV-DNA的高水平载量将显著延长患者术后肝功能恢复时间,同时增加患者术后并发症发生风险。

Objective To investigate the relationship between preoperative HBV-DNA load and postoperative liver function recovery in patients with hepatitis B related hepatocellular carcinoma（ HCC）. Methods A total of 56 patients with HCC treated by radical resection were divided into the low replication group（ serum HBV-DNA load ≤ 104 IU/ml,n = 35） and high replication group（ serum HBV-DNA load ≥ 105 IU/ml,n = 21） according to the HBV-DNA load in serum before operation. The number of cases with changes of HBV-DNA load,changes of liver function indexes such as ALT,AST,ALB and TBIL and time for liver function recovery were observed and compared,and the incidence rates of postoperative complications in two groups were recorded. Results There were no significant changes in serum HBV-DNA load in the two groups before and after operation（ P 0. 05）. Levels of ALT,AST and TBIL in the two groups at 7 days after operation were significantly higher than those at 3 days before operation（ P 0. 05）. ALB levels in the two groups after operation were significantly lower than those before treatment（ P 0. 05）,and levels of ALT and AST in high replication group were significantly higher than those in low replication group（ P 0. 05） but there was no significant difference between the two groups in ALB and ABIL（ P 0. 05）. The time for liver function recovery in the low replication group was significantly shorter than that in the high replication group（ P 0. 05）. The incidence of postoperative complications in the high replication group was significantly higher than that in the low replication group（ 47. 62% vs 17. 14%）（ P 0. 05）. Conclusion： High serum HBV-DNA load in patients with HCC before operation will significantly prolong the time for liver function recovery and increase the risk of complications after operation.