超声引导射频消融术治疗原发性肝癌对患者肝功能及免疫功能的影响

Ultrasound-guided Radiofrequency Ablation for Primary Hepatocellular Carcinoma on Liver Function and Immune Function

目的探讨超声引导射频消融术(RFA)治疗原发性肝癌对患者肝功能及免疫功能的影响。方法选取原发性肝癌患者80例,随机分为手术组与RFA组,每组40例。手术组采取腹腔镜下肝切除术治疗,RFA组采取超声引导下RFA治疗。观察治疗前及治疗后1个月时CD3+、CD4+、CD8+、CD4/CD8、IgA、IgG、IgM、谷丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)及直接胆红素(DBIL)变化,并进行疗效评价。结果2组治疗前CD3+、CD4+、CD8+、CD4+/CD8+水平比较差异无统计学意义(P>0.05);治疗后CD3+、CD4+、CD4+/CD8+均较治疗前升高,且RFA组高于手术组,而CD8+较治疗前下降,且RFA组低于手术组,比较差异均有统计学意义(P<0.05)。2组治疗前血清IgA、IgG、IgM水平比较差异无统计学意义(P>0.05);治疗后IgA、IgG、IgM均较治疗前升高,且RFA组高于手术组,比较差异有统计学意义(P<0.05)。2组治疗前血清ALT、AST、TBIL、DBIL水平比较差异无统计学意义(P>0.05);治疗后ALT、AST、TBIL、DBIL均较治疗前下降,且RFA组低于手术组,比较差异有统计学意义(P<0.05)。手术组与RFA组治疗总有效率分别为92.50%、85.00%,比较差异无统计学意义(P>0.05)。结论RFA用于治疗原发性肝癌有助于改善患者免疫功能及肝功能,治疗整体疗效与手术效果相当。

Objective To investigate the ultrasound-guided radiofrequency ablation(RFA)for primary hepatocellular carcinoma on liver function and immune function.Methods The 80 cases of primary liver cancer patients,the patients were randomly divided into the surgery group and the RFA group,the 40 patients in each group.The control group was treated with laparoscopic hepatectomy,and the observation group was treated with ultrasound-guided RFA.To observed CD3+,CD4+,CD8+,CD4/CD8,IgA,IgG,IgM,glutalanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and direct bilirubin(DBIL)in before treatment and 1 month after surgery,and the curative effect was evaluated.Results There was no significant difference in the levels of CD3+,CD4+,CD8+and CD4+/CD8+between the 2 groups in before treatment(P>0.05),CD3+,CD4+,and CD4+/CD8+were after treatment all higher than those before treatment,and the RFA group were higher than the surgery group,CD8+was lower than that before treatment,and RFA group was lower than that of the surgery group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of IgA,IgG and IgM between the 2 groups in before treatment(P>0.05),there were after treatment all higher than those before treatment,and the RFA group were higher than the surgery group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of ALT,AST,TBIL and DBIL between the two groups in before treatment(P>0.05),there were after treatment all lowerr than those before treatment,and the RFA group were lower than the surgery group,the difference was statistically significant(P<0.05).The total effective rates of the operation group and the RFA group were 94.50%and 85.00%,there was no statistically significant difference(P>0.05).Conclusion Ultrasound-guided RFA for primary hepatocellular carcinoma can improve the immune function and liver function,the overall therapeutic effect was comparable to that of surgery.