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目的 探讨肝癌 (HCC)经多次肝动脉化疗栓塞术 (TACE)后是否加快肝纤维化的发展趋势。方法 选择 2 0例原发性肝癌 (HCC)首诊病人 ,共行 3次TACE术 ,手术间隔时间为 1个月 ,定期测量肝纤维化 4项指标 :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 经统计检验发现HCC病人肝纤维化 4项指标较正常人明显升高 (P <0 0 5 ) ,TACE术后 4项指标呈进行性增高 ,第 2次TACE术后 1个月复查变化明显 (P <0 0 5 ) ,第 3次TACE术后复查指标变化最为显著 (P <0 0 1)。结论 重复进行TACE治疗HCC将加快肝纤维化发展趋势 ,在行TACE治疗时须严格把握适应证。提出在行TACE的同时须加强护肝及肝纤维化逆转的治疗
Objective To investigate whether liver cancer (HCC) accelerates hepatic fibrosis after multiple transcatheter arterial chemoembolization (TACE). Methods Twenty patients with primary hepatocellular carcinoma (HCC) were enrolled in this study. TACE was performed 3 times in total. The interval of operation was 1 month. Four indicators of hepatic fibrosis were regularly measured: hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC Ⅲ) and type Ⅳ collagen (Ⅳ .C) were measured. Twenty healthy controls were selected to measure the above indexes. Results The results showed that four indicators of liver fibrosis in HCC patients were significantly higher than those in normal controls (P <0.05). Four indicators after TACE were significantly increased, and the changes were obvious at one month after TACE (P <0.05). The index of the third retest after TACE was the most significant (P <0.01). Conclusion Repeated TACE treatment of HCC will accelerate the development of liver fibrosis, TACE in the line of treatment should be strictly controlled indications. Proposed TACE in the line while strengthening liver protection and liver fibrosis reversal treatment