摘要
目的探讨肝动脉介入栓塞术治疗肝血管瘤患者的疗效及血清甘氨酰脯氨酸二肽氨基肽酶(GPDA)、高尔基体蛋白73(GP73)和β2-微球蛋白(β2-MG)水平的变化。方法2017年1月~2019年1月我院肝病科收治的60例肝血管瘤患者被随机分为介入手术组30例和开腹肝切除术组30例,分别接受经肝动脉介入栓塞术或开腹肝切除术。术后,随访半年。采用ELISA法检测血清GPDA、GP73、β2-MG水平及肿瘤坏死因子-α(TNF-α)、肿瘤特异性生长因子(TSGF)和甲胎蛋白(AFP)水平。结果介入手术组手术时间和术后住院时间分别为(84.7±21.9)min和(6.7±1.3)d,均显著短于开腹肝切除术组[分别为(126.8±60.5)min和(9.6±5.8)d,P<0.05],术中出血量为(110.7±13.5)mL,显著少于开腹肝切除术组[(315.5±17.8)mL,P<0.05];在术后1 w,介入手术组血清GPDA、GP73、β2-MG、TNF-α、TSGF和AFP水平分别为(62.6±9.8)U/L、(64.3±6.7)μg/L、(1.4±0.5)mg/L、(1.3±0.5)mg/L、(35.5±4.3)U/mL和(2.5±0.6)mg/L,均显著低于开腹肝切除术组[分别为(86.4±11.5)U/L、(112.2±9.3)μg/L,(2.3±0.9)mg/L,(2.1±1.2)mg/L,(61.3±9.8)U/mL和(4.7±0.8)mg/L,P<0.05];介入手术组并发症发生率为13.3%,显著低于开腹肝切除术组(30.0%,P<0.05);在术后随访6 m,介入手术组总有效率为93.3%,显著高于开腹肝切除术组(80.0%,P<0.05)。结论采用肝动脉介入栓塞术治疗肝血管瘤患者疗效较好,且可降低血清GPDA、GP73、β2-MG、TNF-α和TSGF水平,明显改善围术期手术相关指标,减少并发症的发生,具有较高的临床安全性。
Objective The aim of this study was to investigate the efficacy of transhepatic artery embolization(TAE)in treatment of patients with hepatic hemangioma and serum glycylproline dipeptide aminopeptidase(GPDA),Golgi protein 73(GP73)andβ2-microglobulin(β2-MG)level changes.Methods 60 patients with hepatic hemangioma were treated in our hospital between January 2017 and January 2019,and 30 received TAE and another 30 underwent open hepatectomy.After operation,all patients were followed-up for six months.Serum GPDA,GP73,β2-MG,tumor necrosis factor-α(TNF-α),tumor-specific growth factor(TSGF)and alpha-fetoprotein(AFP)were assayed by ELISA.Results The operation time and postoperative hospital stay in TAE-treated patients were(84.7±21.9)min and(6.7±1.3)d,significantly shorter than[(126.8±60.5)min and(9.6±5.8)d,P<0.05],and bleeding during operation was(110.7±13.5)mL,much less than[(315.5±17.8)mL,P<0.05]in those receiving open hepatectomy;1 week after surgery,serum GPDA,GP73,β2-MG,TNF-α,TSGF and AFP levels in the interventional group were(62.6±9.8)U/L,(64.3±6.7)μg/L,(1.4±0.5)mg/L,(1.3±0.5)mg/L,(35.5±4.3)U/mL and(2.5±0.6)mg/L,all significantly lower than[(86.4±11.5)U/L,(112.2±9.3)μg/L,(2.3±0.9)mg/L,(2.1±1.2)mg/L,(61.3±9.8)U/mL and(4.7±0.8)mg/L,respectively,P<0.05]in patients receiving open hepatectomy;the incidence of complications after operation in the interventional group was 13.3%,which was obviously lower than that in the open hepatectomy group(30.0%,P<0.05);the total effective rate in the interventional group at six-month follow-up was 93.3%,which was obviously higher than that in the open hepatectomy group(80.0%,P<0.05).Conclusion The transhepatic artery embolization in the treatment of patients with hepatic hemangioma is efficacious,which might reduce serum GPDA,GP73 andβ2-MG levels,and lead to less post-operational complications.
作者
王宸
张雪斌
程乐
Wang Chen;Zhang Xuebin;Cheng Le(Department of Radiology,Gulou Hospital Affiliated to Nanjing University Medical College,Nanjing 210008,Jiangsu Province,China)
出处
《实用肝脏病杂志》
CAS
2020年第6期905-908,共4页
Journal of Practical Hepatology
基金
南京市科研计划项目(编号:2017ZZ0028)。
