【摘要】 目的 探讨原发性肝癌介入治疗后HBV DNA的变化及临床意义。方法 收集在本科行肝动脉化疗栓塞治疗(TACE)的伴有慢性HBV感染的肝癌患者56例,观察术后血清HBV DNA载量和肝功能的变化。结果 肝癌患者以HBsAg、HBeAb、HBcAb 3项阳性模式最常见(23/56),大部分患者HBV处于复制活跃状态(36/56)。HBeAg(+)及HBeAg(-)模式血清HBV DNA载量差异有统计学意义(P<0.05)。TACE可加重肝功能损害,使血清HBV DNA载量一过性升高(27/56),前者有显著性统计学意义(P<0.01),后者无统计学意义(P>0.05)。术后4周有11例患者血清HBV DNA持续性升高(19.64%),与未升高患者肝功能比较,差异有极显著性统计学意义(P<0.01)。结论 TACE可使部分伴有慢性HBV感染的肝癌患者HBV DNA复制激活,使肝功能损害加剧,术后定期监测血清HBV DNA载量变化具有重要的临床价值。更多还原

【Abstract】 Objective To investigate the changes and clinical significance of serum hepatitis B virus deoxyribonucleic acid(HBV DNA) in patients with hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE).Methods 56 patiens of HCC with chronic HBV infection underwent TACE.The changes of HBV DNA and liver function before and after TACE were evaluated.Results The infection modes of HBV serum markers in 56 cases were mostly HBsAg,anti-HBe and anti-HBc positive modes(23/56).HBV DNA was at replica action in most patients with HCC(36/56).There were significant difference in HBV DNA load between HBeAg(+)-M and HBeAg(-)-M(P<0.05) modes.The liver function of the patients with HCC became worse and HBV DNA load was elevated temporarily(27/56) after TACE,the fomer was significantly different(P<0.01) but the latter was not(P>0.05).There was persistent elevation of serum HBV DNA in 11 patients 4 weeks after TACE(19.64%),and there was statistical significant difference in liver function between elevation of serum HBV DNA and not.Conclusion There is HBV reactivation in some patients with HBV-related HCC after TACE,that causes liver function demage.It was of significant clinic value to monitor the elevation of HBV DNA regularly.更多还原