肝细胞癌患者围手术期病毒载量及肝功能变化

目的:探讨肝细胞癌患者围手术期乙肝病毒DNA载量及肝功能的变化。方法:选取2013年4月-2015年4月本院收治的肝细胞癌患者78例作为研究对象。按照术前血清中HBV-DNA载量的不同，将其分为阴性组14例，低复制组48例，高复制组16例。三组患者均行手术治疗，记录三组患者手术前后7天静脉血清中HBV-DNA载量和术后1天肝功能［谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆红素（TBIL）以及白蛋白（ALB）］变化。结果:手术治疗7天后，阴性组和低复制组患者血清中HBV-DNA载量较治疗前7天有所下降，高复制组患者血清中HBV-DNA载量较治疗前7天有所上升，但无统计学意义（P>0.05）。三组患者手术后的ASL、ALT、TBIL指标较手术前均有明显上升（P＜0.05），三组术后ALB指标较治疗前下降（P＜0.05），且阴性组、低复制组、高复制组术后ASL、ALT、TBIL指标比较有递增变化，ALB指标比较有递减变化。结论:肝细胞癌患者行肝癌根除术后仍然存在HBV复制活跃的问题，HBV活跃程度和术前HBV-DNA载量高水平复制会影响到患者术后肝功能恢复。

Hepatocellular carcinoma (HCC) patients perioperative viral load and the change of liver function

Objective:To explore the HCC patients perioperative HBV-DNA load and the change of liver function.Methods:Total of 78 patients with hepatocellular carcinoma（HCC)，according to the preoperative serum HBV-DNA loads，were divided into negative group with 14 cases，low copy group with 48 cases，high copy group with 16 cases.Three groups of patients were performed surgical treatment and recorded before and after surgery about 7 days serum HBV-DNA loads and liver function（AST,ALT，TBIL and ALB）changes.Results:After surgical treatment of 7 days，serum HBV-DNA loads of patients in negative and low replication group were decreased than pretreatment,and increased in high replication group，with no statistical significance（P>0.05).ALT，AST，TBIL levels of three groups of patients in postoperative 1 day compared with preoperation，were significantly increased（P<0.05).Postoperative ALB level in three groups compared with preoperation was decreased（P<0.05).Postoperative ALT，AST，TBIL levels of three groups of patients were increased gradually，and ALB level was decreased.Conclusion:Hepatocellular carcinoma（HCC） patients with liver cancer eradication remain HBV active replication.HBV active replication and preoperative HBV-DNA loads high level copy will affect postoperative recovery of liver function.