肝细胞癌患者术前ＨＢＶ ＤＮＡ含量对术后肝功能影响的初步研究

目的　探讨肝细胞癌（ＨＣＣ）患者术前ＨＢＶＤＮＡ含量对切除术后肝功能恢复的影响。方法　收集我科２００７年１月至２００７年６月行手术切除治疗的原发性肝癌患者共２１７例，应用实时荧光定量ＰＣＲ方法检测血清中ＨＢＶＤＮＡ，按照ＨＢＶＤＮＡ含量分为两组：Ａ组（ＨＢＶＤＮＡ≥１.０×１０^５拷贝／ｍｌ）６８例，Ｂ组（ＨＢＶＤＮＡ＜１.０×１０^５拷贝／ｍｌ）１４９例。严密观察患者术后肝功能变化情况，采用ＳＰＳＳ１３.０软件进行统计分析。结果　术后两组患者的肝功能变化存在着显著差异，Ａ组的肝功能损伤程度高于Ｂ组。术后第１、３、７天，丙氨酸氨基转移酶（ＡＬＴ）和天门冬氨酸氨基转移酶（ＡＳＴ）数值Ａ组明显高于Ｂ组，而前白蛋白数值则Ｂ组高于Ａ组，两组差异有统计学意义（Ｐ＜００５）；术后第３、７天，总胆红素（ＴＢＩＬ）数值Ａ组明显高于Ｂ组，两组差异有统计学意义（Ｐ＜０.０５）。除术前凝血酶原时间（ＰＴ）、前白蛋白、ＴＢＩＬ、ＡＳＴ和术中肝门阻断时间外，术前ＨＢＶＤＮＡ浓度对术后第７天的血清ＴＢＩＬ水平有显著影响。结论　ＨＣＣ患者术前ＨＢＶＤＮＡ含量对于术后肝功能恢复有明显影响，对术前ＨＢＶＤＮＡ含量较高的患者应在治疗肝癌的同时给予抗病毒治疗。

Effects of hepatitis B virus DNA level on postoperative hepatic function in patients with HCC

Objective To explore short-term effects of serum hepatitis B virus DNA level on hepatic function in patients who underwent hepatectomy of HCC.Methods Clinical data of 217 patients with HCC undergoing hepatectomy between Jan.2007,to Jun.2007,were retrospectively analyzed.Patients were divided into two groups with group A(n=68)in which the hepatitis B virus DNA level was higher than 105 copies/ml,and group B(n=149)in which the level was lower than 105 copies/ml.The changes of postoperative hepatic function in...