抗凝血酶Ⅲ在预测肝细胞癌术后肝衰竭中的应用价值

Value of antithrombin Ⅲ in prediction of liver failure after hepatocellular carcinoma operation

  • 摘要:
      目的  探讨肝细胞癌患者术前血清抗凝血酶Ⅲ(AT-Ⅲ)在预测术后发生肝功能衰竭的应用价值。
      方法  将本院接受肝癌手术的31例患者根据术后肝功能恢复情况分为肝衰竭组(n=7)和非衰竭组(n=24)。比较2组常规肝功能指标及AT-Ⅲ活性,探讨影响肝癌术后肝功能衰竭的危险因素。
      结果  2组总胆红素、AT-Ⅲ活性、白蛋白、血小板、国际标准化比值差异有统计学意义(P < 0.05)。Logistic多因素分析显示,总胆红素、AT-Ⅲ是术后肝衰竭的独立危险因素(P < 0.05)。ROC曲线分析表明, AT-Ⅲ预测术后肝功能衰竭的最佳临界值为87.2%, 其灵敏度和特异度分别为0.807和0.716, 与血清总胆红素相比差异有统计学意义(P < 0.05)。
      结论  AT-Ⅲ是肝癌术后发生肝衰竭的独立危险因素,其在预测术后肝衰竭的灵敏度和特异度较血清总胆红素高。

     

    Abstract:
      Objective  To explore the application value of preoperative serum antithrombin Ⅲ(AT-Ⅲ) in predicting postoperative liver failure in patients with hepatocellular carcinoma.
      Methods  A total of 31 patients who underwent liver cancer surgery in our hospital were divided into hepatic failure group and non-failure group according to the recovery of liver function after hepatectomy. The routine liver function indexes and AT-Ⅲ activity were compared between the two groups, and the risk factors of hepatic failure after hepatectomy were explored.
      Results  There were significant differences in total bilirubin, AT-Ⅲ activity, albumin, platelet and international standardized ratio between the two groups (P < 0.05). Logistic multivariate analysis showed that total bilirubin and AT-Ⅲ were independent risk factors of liver failure after hepatectomy (P < 0.05). ROC curve analysis showed that the best critical value of AT-Ⅲ for predicting liver failure after operation was 87.2%. The sensitivity and specificity were 0.807 and 0.716, respectively, which showed a significant difference compared with serum total bilirubin (P < 0.05).
      Conclusion  AT-Ⅲ is an independent risk factor for hepatic failure after hepatocellular carcinoma operation, which has higher sensitivity and specificity in predicting hepatic failure after operation than serum total bilirubin.

     

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