原发性肝癌TACE前后血清前白蛋白检测的临床价值

CLINICAL VALUE OF SERUM PREALBUMIN IN TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION OF PRIMARY LIVER CANCER (

目的 观察原发性肝癌插管化疗栓塞 (TACE)治疗前后血清前白蛋白 (PA )的变化。方法 回顾性分析 1 5 0例接受肝动脉插管化疗栓塞的中晚期肝癌患者治疗前后血清 PA的变化并与常规肝功能比较。结果 本组 TACE后肝功能不全 2 6例 (1 7.33% ) ,死于肝功能衰竭 3例 (2 .0 % )。 PA在 TACE后第 1 d即有明显下降 ,术后 1周左右降至最低 (8.6± 3.5mg/dl) ,以后逐渐升高 ,于术后 4周左右恢复至 TACE前水平。 TACE 3次者术前及术后 1周 PA水平分别为 1 3.2± 3.0 mg/dl,6 .9± 3.3m g/dl,与 TACE 1次或 2次比较差异显著 ;常规栓塞术后 1周 PA水平 (6 .7± 2 .4 mg/dl)较肝段栓塞低 (1 0 .7±3.4 m g/dl) (P>0 .0 1 ) ;碘油用量低于 1 5 m l者术后 1周 PA水平 (9.1± 3.7m g/dl)与碘油用量超过 1 5 m l者 (7.0± 2 .3mg/dl)比较差异显著 (P<0 .0 1 ) ;有门静脉癌栓者术前及术后 1周 PA分别为 1 2 .4± 2 .1 m g/dl,5 .8± 1 .9m g/dl,无癌栓者术前及术后 1周 PA分别为 1 6 .7± 3.3mg/dl,9.2± 3.5 mg/dl,两两比较差异显著 (P<0 .0 1 )。结论 TACE对肝功能的损害随着治疗次数和碘油用量的增加而加重 ,有门静脉癌栓者肝功能的损害更加明显 ,肝段栓塞可以减轻肝功能的损害。血清 PA可以敏感地反映 TACE各种因素?

Objective To observe the peri therapeutical changement of serum prealbumin(PA) in primary liver cancer patients underwment transcatheter arterial chemoembolization (TACE).Methods The clinical materials of 150 unresectable primary liver cancer patients underwent TACE were analyzed retrospectively,the peri therapeutical serum level of PA and the correlationship between PA and routinal liver function test were investigated.Result After TACE,there were 26 patients(17.33%)suffered from liver function failure,among which,3 patients died(2%).The serum level of PA decreased significantly at the first day after TACE,and it still decreased to the lowest degree of 8.6±3.5 mg/dl in average about 1 week after TACE,then it began to rise gradually to its pre therapeutical level about 4 weeks after TACE.The abnormal rate of PA after TACE was much higer than those of ALB and Tbil.The PA level of pre treatment and 1 week after treatment in patients underwent 3 times TACE were 13.2±3.0 mg/dl and 6.9±3.3 mg/dl respectively.As compared with chose of patients underwent 1 or 2 time TACE,the difference was signficant.The serum level of PA at 1 week after treatment in patients accepted routinal TACE(6.7±2.4 ng/dl) was much lower than that of patients underwent segmental TACE (10.7±3.4 mg/dl)( P <0.01).The serum level of PA at 1 week after treatment in patients with or without portal vein cancer thrombus were 12.4±2.1 mg/dl and 5.8±1.9 mg/dl or 16.7±3.3 mg/dl and 9.2±3.5 mg/dl respectively,there were significant difference between each other( P <0.01).Conclusion The damage of liver function resulted from TACE will be more severe if lipidol amount and the times of TACE become much more and if the there is cancer thrombus in portal vein,the damage can be declined if we adopt segmental TACE.The serum value of PA can sensitively and exactly reflect the damage of liver function caused by some factors in TACE,and we can chose some medicine to pretect the liver function in time by testing the serum level of PA.