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目的 探讨原发性肝癌 (HCC)经多次肝动脉化疗栓塞术 (TAE)后肝纤维化指标的变化。方法 选择 2 0例HCC首诊患者 ,共行 3次TAE术 ,术中间隔时间为 30～ 45d ,在每次术前 2 4h测量肝纤维化 4项检测指标 :透明质酸 (HA)、层粘连蛋白 (LN)、Ⅲ型前胶原 (PCⅢ )、Ⅳ型胶原 (Ⅳ .C)的含量 ,并选取 2 0例健康人测量以上指标作为对照。结果 经统计学方法检验发现HCC患者肝纤维化 4项指标均较正常人明显升高 (Ρ <0 .0 5 ) ,首次TAE术后与术前 4项指标相比变化不显著 (Ρ >0 .0 5 ) ,第 2次TAE术后复查变化明显 (Ρ <0 .0 5 ) ,第 3次TAE术后复查指标变化最为显著 (Ρ <0 .0 1)。结论 反复多次进行TAE治疗HCC将加快肝纤维化的形成 ,在行TAE治疗时须严格把握手术适应证 ,术中必须强调超选择栓塞 ,术后须加强护肝治疗。
Objective To investigate the changes of hepatic fibrosis indexes after primary hepatic artery chemoembolization (TAE) in primary hepatocellular carcinoma (HCC). Methods Twenty patients with primary HCC were enrolled in this study. TACE was performed 3 times in each group. The interval time was 30-45 days. Four indexes of liver fibrosis, including hyaluronic acid (HA), layer (LN), type Ⅲ procollagen (PC Ⅲ) and type Ⅳ collagen (Ⅳ .C) were measured. 20 healthy people were selected to measure the above indexes as control. Results The statistical analysis showed that the four indexes of liver fibrosis in HCC patients were significantly higher than those in normal controls (P <0.05), but no significant change (P> 0) after the first TAE .0 5). The second postoperative TAE changed significantly (P <0.05). The third postoperative TAE showed the most significant change (P <0.01). Conclusion Repeated TAE treatment of HCC will speed up the formation of liver fibrosis. TAE should strictly observe the indications for surgery. Oesophageal echocardiography should be emphasized during operation, and liver protection should be strengthened after operation.