乳果糖对原发性肝癌射频消融术患者肝功能及血清急相反应蛋白的影响

目的观察乳果糖对原发性肝癌患者射频消融术后ALT、AST、C反应蛋白和降钙素原水平的影响。方法 132例原发性肝癌患者被随机分为对照组和乳果糖治疗组。在射频消融术前后,对照组按常规治疗,治疗组加服乳果糖。两组均在射频消融前后检测ALT、AST、甲胎蛋白、C反应蛋白和降钙素原水平。结果治疗组在治疗后3天,患者C反应蛋白和降钙素原分别为15.42±3.81mg/L和13.85±4.67μg/L,与治疗前水平(14.23±4.65mg/L和12.28±4.45μg/L)相比,差异无显著性,但在1周后两者分别下降至4.56±1.38mg/L和4.35±2.12μg/L,显著低于治疗前水平(P<0.05);治疗后3天对照组患者C反应蛋白和降钙素原上升至20.36±7.72mg/L和17.62±9.43μg/L,显著高于治疗前水平(14.21±4.47mg/L和12.16±8.37μg/L,P<0.05),但治疗后1周分别下降至12.28±7.36mg/L和11.01±8.24μg/L;术后3天ALT(89±47U/LL)和AST(71±38U/L)均由基线水平显著上升(115±53U/L和107±54U,P<0.05),但术后1周下降至接近基线水平(63±32U/L和60±34U/L);治疗组甲胎蛋白水平由基线(1307±697ng/ml)持续下降(术后3天为875±653ng/ml,术后1周为201±171ng/ml,P均<0.01)。结论乳果糖显著改善原发性肝癌患者在射频消融术后肝功能状态,并减轻机体的炎症反应,可能对促进术后机体的恢复有一定的意义。

Effects of lactulose on liver function and acute phase proteins in patients underwent radiofrequency ab-lation for hepatocellular carcinoma

Objective To study the effects of lactulose on liver function and acute phase proteins （C-reac-tion protein and procalcitonin）in patients underwent radiofrequency ablation for hepatocellular carcinoma （HCC）. Method 132 patients with HCC were randomly divided into control and treatment group. The patients in controls were treated with conventional therapy and patients in the treatment group were treated with lactulose additionally. The serum alanine aminotransferase（ALT）,aspartate transaminase（AST）,alpha fetoprotein（AFP）,CRP and procalci-tonin （PCT）were measured before and after the procedure. Results In the treatment group,serum CRP and PCT were 15.42±3.81mg/L and 13.85±4.67μg/L 3 days after the treatment,respectively,which were not significantly dif-ferent as compared to these at the baseline（14.23±4.65 mg/L and 12.28±4.45μg/L,respectively）,however,the CRP and PCT decreased to 4.56 ±1.38mg/L and 4.35 ±2.12μg/L one week after the treatment （P〈0.05）;In the control group,the CRP and PCT levels at baseline were 14.21±4.47mg/L and 12.16±8.37μg/L,respectively,which increased to 20.36±7.72mg/L and 17.62±9.43μg/L,respectively 3days after the treatment（P〈0.05）,but decreased to levels（12. 28±7.36mg/L or 11.01±8.24μg/L）similar to the baseline one week after the treatment;The serum ALT （89±47u/L） and AST（71±38u/L） increased from the baseline to 115±53u/L and 107±54u/L 3 days after the treatment（P〈0.05） and then decreased to 63 ±32u/L or 60 ±34u/L one week after the treatment;Serum AFP levels were significantly decreased from the baseline （1307±697ng/ml）to 875±653ng/ml 3 days or 201±171ng/ml 1 weeks,respectively after the treatment （P〈0.01）. Conclusions Lactulose improves liver function and ameliorates inflammatory response af-ter radiofrequency ablation in patients with hepatocellular carcinoma.