乙氨醚代谢试验对肝癌患者肝脏贮备功能评价研究

目的探讨乙氨醚代谢试验在原发性肝癌患者肝脏贮备功能评价中的应用。方法38例原发性肝癌患者，其中非肝硬化15例，肝硬化23例，术前行常规肝功能检测与乙氨醚代谢试验，术后行病理学检查。监测并发症和预后。比较非肝硬化组与肝硬化组、有并发症组与无并发症组、预后良组与预后差组、ChildA组与非ChildA组乙氨醚及其代谢产物对乙酰氨基酚血浓度。结果在肝硬化与非肝硬化患者、有并发症与无并发症患者、预后差与预后良患者、ChildA级与非ChildA级患者，对乙酰氨基酚与乙氨醚的血浓度及其比值有统计学差异（P〈0．01），预后差与预后良患者组间凝血酶原时间有统计学差异，其他常规肝功能指标均无统计学差异（P〉0．05）。结论乙氨醚代谢试验评价肝脏功能比现有分级方法更为灵敏、可靠。

Experimental study of phenacetin metabolism on evaluation of liver reserve function of patients with hepatic carcinoma

Objective To study metabolism of phenacetin on evaluation of liver reserve function in patients with primary hepatic carcinoma. Methods Routine preoperative liver function tests and phenacetin metabolism experiment were finished in 38 patients with primary liver cancer. Phenacetin and its metabolites-acetaminophen concentration in the blood, postoperative complications, prognosis were observed. Results In patients with non- cirrhosis and cirrhosis,patients with complications and without complications, patients with poor prognosis and good prognosis,patients with Child A and non-Child A grade, blood acetaminophen, phenaeetin and its ratios were significantly different （ P 〈 0. 01 ）. Except the prothrombin time were significantl.y different in patients with poor prognosis and good prognosis, other conventional liver function parameters had no significant differences in above patients（P 〉 0. 05 ）. Conclusions Experimental evaluation of phenacetin metabolism in liver function is more sensitive and reliable than other methods.