CAJ | 학술논문

　　目的观察乳果糖对原发性肝癌患者射频消融术后ALT、AST、C反应蛋白和降钙素原水平的影响。方法132例原发性肝癌患者被随机分为对照组和乳果糖治疗组。在射频消融术前后，对照组按常规治疗，治疗组加服乳果糖。两组均在射频消融前后检测ALT、AST、甲胎蛋白、C反应蛋白和降钙素原水平。结果治疗组在治疗后3天，患者C反应蛋白和降钙素原分别为15.42±3.81mg/L和13.85±4.67μg/L，与治疗前水平（14.23±4.65mg/L和12.28±4.45μg/L）相比，差异无显著性，但在1周后两者分别下降至4.56±1.38mg/L和4.35±2.12μg/L，显著低于治疗前水平（P<0.05）；治疗后3天对照组患者C反应蛋白和降钙素原上升至20.36±7.72mg/L和17.62±9.43μg/L，显著高于治疗前水平（14.21±4.47mg/L和12.16±8.37μg/L，P<0.05），但治疗后1周分别下降至12.28±7.36mg/L和11.01±8.24μg/L；术后3天ALT（89±47U/LL）和AST（71±38U/L）均由基线水平显著上升（115±53U/L和107±54U，P<0.05），但术后1周下降至接近基线水平（63±32U/L和60±34U/L）；治疗组甲胎蛋白水平由基线（1307±697ng/ml）持续下降（术后3天为875±653ng/ml，术后1周为201±171ng/ml，P均<0.01）。结论乳果糖显著改善原发性肝癌患者在射频消融术后肝功能状态，并减轻机体的炎症反应，可能对促进术后机体的恢复有一定的意义。
　　목적관찰유과당대원발성간암환자사빈소융술후ALT、AST、C반응단백화강개소원수평적영향。방법132례원발성간암환자피수궤분위대조조화유과당치료조。재사빈소융술전후，대조조안상규치료，치료조가복유과당。량조균재사빈소융전후검측ALT、AST、갑태단백、C반응단백화강개소원수평。결과치료조재치료후3천，환자C반응단백화강개소원분별위15.42±3.81mg/L화13.85±4.67μg/L，여치료전수평（14.23±4.65mg/L화12.28±4.45μg/L）상비，차이무현저성，단재1주후량자분별하강지4.56±1.38mg/L화4.35±2.12μg/L，현저저우치료전수평（P<0.05）；치료후3천대조조환자C반응단백화강개소원상승지20.36±7.72mg/L화17.62±9.43μg/L，현저고우치료전수평（14.21±4.47mg/L화12.16±8.37μg/L，P<0.05），단치료후1주분별하강지12.28±7.36mg/L화11.01±8.24μg/L；술후3천ALT（89±47U/LL）화AST（71±38U/L）균유기선수평현저상승（115±53U/L화107±54U，P<0.05），단술후1주하강지접근기선수평（63±32U/L화60±34U/L）；치료조갑태단백수평유기선（1307±697ng/ml）지속하강（술후3천위875±653ng/ml，술후1주위201±171ng/ml，P균<0.01）。결론유과당현저개선원발성간암환자재사빈소융술후간공능상태，병감경궤체적염증반응，가능대촉진술후궤체적회복유일정적의의。
Objective To study the effects of lactulose on liver function and acute phase proteins (C-reac-tion protein and procalcitonin)in patients underwent radiofrequency ablation for hepatocellular carcinoma (HCC). Method 132 patients with HCC were randomly divided into control and treatment group. The patients in controls were treated with conventional therapy and patients in the treatment group were treated with lactulose additionally. The serum alanine aminotransferase(ALT),aspartate transaminase(AST),alpha fetoprotein(AFP),CRP and procalci-tonin (PCT)were measured before and after the procedure. Results In the treatment group,serum CRP and PCT were 15.42±3.81mg/L and 13.85±4.67μg/L 3 days after the treatment,respectively,which were not significantly dif-ferent as compared to these at the baseline(14.23±4.65 mg/L and 12.28±4.45μg/L,respectively),however,the CRP and PCT decreased to 4.56 ±1.38mg/L and 4.35 ±2.12μg/L one week after the treatment (P<0.05);In the control group,the CRP and PCT levels at baseline were 14.21±4.47mg/L and 12.16±8.37μg/L,respectively,which increased to 20.36±7.72mg/L and 17.62±9.43μg/L,respectively 3days after the treatment(P<0.05),but decreased to levels(12. 28±7.36mg/L or 11.01±8.24μg/L)similar to the baseline one week after the treatment;The serum ALT (89±47u/L) and AST(71±38u/L) increased from the baseline to 115±53u/L and 107±54u/L 3 days after the treatment(P<0.05) and then decreased to 63 ±32u/L or 60 ±34u/L one week after the treatment;Serum AFP levels were significantly decreased from the baseline (1307±697ng/ml)to 875±653ng/ml 3 days or 201±171ng/ml 1 weeks,respectively after the treatment (P<0.01). Conclusions Lactulose improves liver function and ameliorates inflammatory response af-ter radiofrequency ablation in patients with hepatocellular carcinoma.