| Jingyan Wang,Linzhi Zhang,Xiaoming Peng,Yun Zhao,Lin Zhou. Evaluation of the safety and efficacy of glucocorticoid therapy for hyperbilirubinemia in patients with hepatocellular carcinoma who have undergone transcatheter arterial chemoembolization. Oncol Transl Med, 2020, 6: 81-86. |
| 糖皮质激素治疗原发性肝细胞癌患者TACE术后高胆红素血症的安全性及有效性评价 |
| Evaluation of the safety and efficacy of glucocorticoid therapy for hyperbilirubinemia in patients with hepatocellular carcinoma who have undergone transcatheter arterial chemoembolization |
| Received:December 26, 2019 Revised:April 16, 2020 |
| DOI：10.1007/s10330-019-0398-8 |
| 中文关键词: 糖皮质激素；原发性肝癌；高胆红素血症；肝动脉化疗栓塞术 |
| 英文关键词: glucocorticoid; primary liver cancer; hyperbilirubinemia;transcatheter arterial chemoembolization (TACE |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Jingyan Wang | The Fifth Medical Center of PLA General Hospital | wangjingyan.yan@163.com | | Linzhi Zhang | The Fifth Medical Center of PLA General Hospital | | | Xiaoming Peng | The Fifth Medical Center of PLA General Hospital | | | Yun Zhao | The Fifth Medical Center of PLA General Hospital | | | Lin Zhou* | The Fifth Medical Center of PLA General Hospital | lindagery302@163.com |
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| 中文摘要: |
| 目的 分析糖皮质激素治疗原发性肝细胞癌（HCC）患者肝动脉化疗栓塞术（TACE）后高胆红素血症的安全性及有效性。方法 回顾性分析解放军总医院第五医学中心2014年6月-2019年8月住院期间TACE治疗术后合并高胆红素血症的198例HCC患者的临床资料，根据是否使用糖皮质激素分为治疗组和对照组，两组患者均给予常规药物保肝治疗，治疗组加用注射用甲泼尼龙琥珀酸钠治疗3-5天，通过对比两组患者的胆红素下降情况、平均住院时间、并发症情况等指标，来分析糖皮质激素治疗TACE术后高胆红素血症的安全性及有效性。结果 两组患者在TACE治疗术后的主要肝功能指标均较术前明显升高，两组相比无统计学差异（P ＞0.05）。经过糖皮质激素和/或常规保肝治疗，治疗组在入组治疗后3天、5天胆红素较对照组明显下降（P ＜0.05）。治疗组的总住院时间、术后住院时间、症状恢复时间也较对照组明显缩短（14.5±4.6 v.s. 17.5±6.6 P ＜0.001; 9.2±3.3 v.s. 11.8±5.4 P =0.001; 7.0±3.3 v.s. 9.3±4.6 P ＜0.001），治疗组未发生明显糖皮质激素相关并发症。结论 短期应用糖皮质激素治疗HCC患者TACE术后高胆红素血症胆红素下降快、住院时间短，安全性好。 |
| 英文摘要: |
| Objective The aim of this study was to analyze the safety and efficacy of glucocorticoid treatment for
hyperbilirubinemia in patients with hepatocellular carcinoma (HCC) who have undergone transcatheter
arterial chemoembolization (TACE).
Methods We conducted a retrospective analysis of the clinical data of 198 patients with HCC who
were admitted to The Fifth Medical Center of PLA General Hospital from June 2014 to August 2019
and underwent TACE therapy. The patients were divided into glucocorticoid (GCC) treatment group and
control group. Standard liver-protecting procedures were used in both groups. The treatment group also
received intravenous injections of methylprednisolone sodium succinate for 3–5 days. Reduction in bilirubin
concentration, mean duration of hospitalization, and complications were compared between the two groups
to investigate the safety and efficacy of GCCs for treatment of hyperbilirubinemia after TACE treatment.
Results Bilirubin concentrations were significantly lower in the treatment group than in control group
on days 3 and 5 after GCC/conventional liver-protecting treatment (P < 0.05). The treatment group had
significantly shorter durations of total post-surgery hospitalization, and recovery time than the control group
(14.5 ± 4.6 days vs. 17.5 ± 6.6 days, P < 0.001; 9.2 ± 3.3 days vs. 11.8 ± 5.4 days, P = 0.001; 7.0 ± 3.3
days vs. 9.3 ± 4.6 days, P < 0.001). No GCC-associated complications were detected in the treatment
group.
Conclusion Short-term use of GCCs to treat hyperbilirubinemia in patients with HCC who have
undergone TACE is safe and associated with rapid decline in bilirubin concentration and shorter hospital
stay compared with patients who did not receive GCCs. |
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