不同Child分级的高HBVDNA滴度原发性肝癌介入治疗后肝功能损害的对比研究

目的对比不同Child分级的高HBVDNA滴度肝癌患者接受介入治疗后肝功能损伤程度的差异。方法对2008年10月至2011年10月收治的80例高HBVDNA滴度的原发性肝癌患者，Child A级50例，Child B级30例，均给予介入治疗，比较两组在介入治疗后6个月内肝功能损伤的差异。结果两组出现肝功能损害的时间均在介入治疗后2周～1个月内，差异无统计学意义（P〉0．05）；但两组肝功能恢复时间差异有统计学意义（P〈0．05）。Child B级组患者肝功能指标在介入治疗后明显升高，损害程度主要为Ⅱ、Ⅲ度，差异与Child A级组比有统计学意义（P〈0．05）。在介入治疗后2个月ChildA级和B级患者肝功能正常率分别为83％和50％（P〈0．01）；4个月肝功能正常率分别为88％和67％（P〉0．05）；6个月肝功能正常率分别为92％和80％（P〉0．05）。结论高HBVDNA滴度Child B级肝癌患者在接受介入治疗后，肝功能损害程度明显，损伤比例较高，提示介入治疗前联合HBVDNA滴度和Child分级评价介入治疗指征的重要性。

Analysis of the hepatic function damage in patients of hepatocellular carcinoma with high lever of HBVDNA between Child A and B after trans-catheter arterial chemo-ebolization

Objective To study the liver function damage in patients of hepatocellular carcinoma with high lever of HBVDNA between Child A and B after trans-catheter arterial 80 primary hepatocellular carcinoma patients with high lever HBVDNA. The subjects were divided into two groups： Child A group （50 cases） and Child B group（30 cases）. We compared the differences of the two groups in hepatic function damage in 6 months after TACE. Results The hepatic function damage happened from 2 weeks to 1 month in both Child A and Child B groups, and had no statistical significance, but the recovery time of liver function had statistical significance with Child B. The parameters of liver function were significantly higher in Child B after TACE. The normal liver function rate were 83% and 50% respectively in 2-month after TACE, and had significant difference（ P 〈 0.01 ）, 88% and 67% respectively in 4-month（P 〉 0.05 ）, 92% and 80% in 6-month（P 〉 0.05 ）. Conclusions The degree of liver function damage and the rate of liver function are more obviously in Child B with high lever of HBVDNA received TACE. It was important to estimate the indication curative of TACE by the lever of HBVDNA and Child-paugh score.