经导管动脉栓塞化疗治疗间隔对老年原发性肝癌患者肝功能、凝血功能、免疫功能的影响

Effect of transcatheter arterial chemoembolization treatment interval on liver function,coagulation function and immune function of elderly patients with primary liver cancer

目的探讨经导管动脉栓塞化疗(TACE)治疗间隔对老年原发性肝癌患者肝功能、凝血功能、免疫功能的影响。方法根据两次TACE治疗间隔的不同将96例老年原发性肝癌患者分为短间隔组(n=50,两次TACE治疗间隔≤61天)和长间隔组(n=46,两次TACE治疗间隔﹥61天)。比较两组患者的肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)]、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、D-二聚体(D-D)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。结果首次术前、首次术后6天,两组患者的ALT、AST、TBIL、APTT、PT、TT、D-D、CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)比较,差异均无统计学意义(P﹥0.05)。二次术前、二次术后6天,短间隔组患者的ALT、AST、TBIL、D-D、CD8^(+)水平均低于长间隔组,APTT均长于长间隔组,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于长间隔组,差异均有统计学意义(P﹤0.05)。结论较短的TACE治疗间隔对老年原发性肝癌患者肝功能、凝血功能、免疫功能的损伤较小,建议临床根据患者病情合理选择TACE治疗间隔。

Objective To explore the effect of transcatheter arterial chemoembolization(TACE)treatment interval on liver function,coagulation function and immune function of elderly patients with primary liver cancer.Method A total of 96 elderly patients with primary liver cancer were divided into short interval group(n=50,the interval between two TACE treatments≤61 days)and long interval group(n=46,the interval between two TACE treatments>61 days)according to the difference of TACE treatment interval.The liver function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)],coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),D-dimer(D-D)]and immune function indexes(CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+))were compared between the two groups.Result Before the first surgery and 6 days after the first surgery,there were no significant differences in ALT,AST,TBIL,APTT,PT,TT,D-D,CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).Before the second surgery and 6 days after the second surgery,the ALT,AST,TBIL,D-D and CD8^(+)levels in the short interval group were lower than those in the long interval group,APTT was longer than that in the long interval group,and CD3^(+),CD4^(+)levels and CD4^(+)/CD8^(+)were higher than those in the long interval group,and the differences were statistically significant(P<0.05).Conclusion Shorter TACE treatment interval has less damage to liver function,coagulation function and immune function in elderly patients with primary liver cancer.It is suggested that reasonable selection of TACE treatment interval should be made according to the patient’s condition.