围术期应用异甘草酸镁对原发性肝癌介入治疗患者肝功能的保护作用

Protective effect of magnesium ISO glycyrrhizate for protection of liver function in patients with primary liver cancer during perioperative period

目的探讨围术期应用异甘草酸镁对原发性肝癌介入治疗患者肝功能的保护作用。方法前瞻性研究北京佑安医院于2014年6月至2017年6月期间收治的行介入治疗的原发性肝癌患者86例,按照随机表法分为观察组43例与对照组43例。两组均行经皮肝动脉化疗栓塞术介入治疗。对照组于治疗前3 d至结束后7 d静脉注射硫普罗宁;观察组于治疗前3 d至结束后7 d静脉注射异甘草酸镁。比较两组治疗疗效,治疗前后肝功能和肝脏血流速度变化,及不良反应发生情况。结果观察组患者总有效率(76.74%)与对照组(69.77%)相比,无统计学差异(P>0.05)。两组治疗后ALT、AST和TBIL水平均较治疗前明显下降,差异有统计学意义(观察组:t=22.439、20.470、41.223,对照组:t=9.041、8.768、19.783,P<0.05);观察组治疗后ALT、AST和TBIL水平明显低于对照组,差异均有统计学意义(t=13.358、15.645、20.282,P<0.05)。两组治疗后肝动脉最大血流速度(Vmax)和最低血流速度(Vmin)较治疗前明显上升,差异有统计学意义(观察组:t=7.811、8.889,对照组:t=19.193、3.988,P<0.05);观察组治疗后肝动脉Vmax和Vmin均明显高于对照组,差异有统计学意义(t=10.570、6.063,P<0.05)。观察组不良反应发生率(11.63%)低于对照组(32.56%),差异有统计学意义(P<0.05)。结论围术期应用异甘草酸镁可明显改善原发性肝癌介入治疗患者的肝功能,提高肝动脉血流速度,且不良反应少,用药安全性良好,值得临床推广应用。

Objective To explore the effect of magnesium ISO glycyrrhizate on protection of liver function in patients with primary liver cancer during perioperative period. Methods A total of 86 patients with primary liver cancer received interventional therapy in this hospital during June 2014 to June 2017 were selected for this prospective study,and they were divided into observation group（ 43 cases） and control group（ 43 cases） according to random table method. Patients in these two groups were treated with transcatheter hepatic arterial chemoembolization. In patients of control group,the sulphur Pronin was introvenously injected at 3 days before the treatment to 7 days after the end of treatment,and patients in observation group were injected with magnesium ISO GGM at 3 d before treatment to 7 days aafter the end of treatment. The curative effect of these two groups was compared,the changes in liver function and the velocity of blood flow in liver before and after treatment,and the occurrence of adverse reactions were compared. Results The total effective rate of patients in inspection group（ 76. 74%） compared with that（ 69. 77%） of control group,there was no statistical difference（ P〈0. 05）. After treatment,the levels of ALT,AST and TBIL in these two groups decreased in comparison with those before treatment,and the difference was statistically significant（ observation group： t = 22. 439,20. 470,41. 223,control group： t = 9. 041,8. 768,19. 783,P〈0. 05）. The levels of ALT,AST and TBIL in observation group were lower than those of control group,and the difference was statistically significant（ t = 13. 358,15. 645,20. 282,P〈0. 05）. After treatment,the Vmax and Vmin of these two groups were increased compared with those before treatment,and the diffeerence was statistically significant（ observation group： t = 7. 811,8. 889,control group： t = 19. 193,3. 988,P〈0. 05）. Vmax and Vmin of hepatic artery in observation group were higher than those of control group,with significant statistical difference（ t = 10. 570,6. 063,P〈0. 05）. The incidence of adverse reactions in observation group（ 11. 63%） was lower than that of control group（ 32. 56%）,with statistical difference（ P〈0. 05）. Conclusion Perioperative application of magnesium ISO glycyrrhizate can significantly improve the liver function of patients with primary liver cancer after interventional therapy,the velocity of blood flow in hepatic artery had been improved,with fewer adverse reactions,and the safety of drug is good,so it is worthy to be clinically appled.