经TACE治疗及降糖药物治疗的原发性肝癌并2型糖尿病Child—Pugh分级变化危险因素分析

目的探讨接受降糖药物治疗的原发性肝癌并2型糖尿病患者经TACE治疗Child-Pugh分级变化的相关因素。方法回顾性分析TACE治疗接受降糖药物治疗的原发性肝癌并2型糖尿病患者126例；主要研究年龄、性别、Child-Pugh分级、二甲双胍治疗、服用其他口服降糖药治疗、是否接受肝癌手术后、糖化血红蛋白（HbAlc）、体质量指数（BMI）、既往有无发生酮症或高渗、超选择栓塞肿瘤供血支与否、胰岛素治疗及有无动静脉瘘等相关数据。观察术前后Child-Pugh分级变化，分析相关因素。结果单因素分析结果显示：既往有无发生酮症或高渗、超选择栓塞肿瘤供血支与否、胰岛素治疗及有无动静脉瘘手术前后Child-Pugh分级肝功能变化差异有统计学意义（P〈0．05）。Logistic回归分析显示：胰岛素治疗（P=0．006）、超选择栓塞肿瘤供血支与否（P=0．037）及有无动静脉瘘（P=0．003）与接受降糖药物治疗的原发性肝癌并2型糖尿病患者TACE术后肝功能Child．Pugh评分变化相关。结论胰岛素治疗、超选择栓塞肿瘤供血支与否及有无动静脉瘘是影响接受降糖药物治疗的原发性肝癌并2型糖尿病患者TACE术后肝功能主要因子。

Analysis of risk factors for fiver function for hepatocellular carcinoma with type 2 diabetes receiving antidiabetic drug therapy after transcatheter arterial chemoembolization

Objective To study risk factors for change of Child-Pugh classification in HCC （hepatocellular carcinoma） patients with with type 2 diabetes receiving antidiabetic drug therapy after transcatheter arterial chemoembolization （TACE）. Methods The clinical data of 126 cases undergoing HCC patients with type 2 diabetes receiving antidiabetic drug therapy in the hospital were reviewed retrospectively, including sex, age, Child-Pugh classification, Metformin therapy, taking other oral hypoglycemic agents, surgery history of HCC, glycosylated hemoglobin （HbAlc）, body mass index （BMI）, without previous ketosis or hypertonic, super- selective supply artery embolization, insulin therapy and the presence of arteriovenous fistula. The change of Child-Pugh classification was observed for risk factor analysis before and after TACE. Results Univariate analysis showed that previous ketosis or hypertonic, super-selective supply artery embolization, insulin therapy and the presence of arteriovenous fistula were the risk factors for liver function for HCC with type 2 diabetes receiving antidiabetic drug therapy after TACE （P〈0.05）. Multivariate Logistic analysis regression revealed that super-selective supply artery embolization （P=0.037）, insulin therapy （P=-0.006） and the presence of arteriovenous fistula（P=0.003） were independent risk factors for liver function for HCC with type 2 diabetes receiving antidiabetic drug therapy after TACE. Conclusions Super-selective supply artery embolization,insulin therapy and the presence of arteriovenous fistula were main factors affecting liver function for HCC with type 2 diabetes receiving antidiabetic drug therapy after TACE.