老年肝细胞癌患者手术前后 HBV-DNA及肝功能变化的研究

吴朝霞

doi:10.7619/jcmp.201413013

老年肝细胞癌患者手术前后 HBV-DNA及肝功能变化的研究

吴朝霞

Change of HBV-DNA and liver function before and after surgery in patients with hepatic cellular cancer

WU Zhaoxia

摘要

摘要: 目的：研究老年肝细胞癌患者行肝癌根治术前后 HBV-DNA 载量及肝功能变化，并探讨 HBV-DNA 载量对于术后患者肝功能恢复状况的预测价值。方法分析2011年1月-2013年1月在本院接受住院手术治疗的肝细胞癌患者的临床资料，根据术前 HBV-DNA 载量分为阴性组、低复制组、中复制组和高复制组四组。比较4组患者术前术后的 HBV-DNA 载量及肝功能变化。结果本研究共入组患者65例，其中阴性组10例，低复制组27例，中复制组18例和高复制组10例。手术治疗1周后，阴性组和低复制组患者的HBV-DNA载量有所下降，而中、高复制组载量有所升高，但差异均无统计学意义（P均＞0．05）；4组患者术后第一天的 ALT、AST 水平均显著高于术前水平（P 均＜0．01），Alb 水平有所下降，差异有统计学意义（P 均＜0．05）。TBIL 术前术后差值并无统计学意义（P 均＞0．05）；术前 HBV-DNA 载量对术后患者肝功能恢复时间的预测价值曲线下面积为0．901，敏感性为77．65％，特异性为87．24％。结论HCC 患者手术后的 HBV 的复制仍然很活跃，术前 HBV-DNA载量对于术后患者肝功能恢复时间有着一定的预测价值。

Abstract: Objective To analyze the change of HBV-DNA and liver function before and af-ter surgery in patients with hepatic cellular cancer.Methods Clinical materials of patients with were retrospectively analyzed.They were divided into 4 groups according to the level of HBV-DNA before surgery.Results The liver function of patients decreased significantly after surgery.The.There was no significant difference of TBIL before and after operation.ROC of preoperative HBV-DNA value in prediction of recovery time of postoperative liver function was 0.901,sensitivity was 77.65%,and specificity was 87.24%.Conclusion Level of HBV-DNA shows a significant meaning in the predic-tion of the recovery time of liver function.

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