Ishikawa Toru, Michitaka Imai, Kamimura Hiroteru, Higuchi Kazuo, Kubota Tomoyuki, Seki Kei-ichi, Ohta Hironobu, Yoshida Toshiaki, Kamimura Tomoteru
Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Niigata, Japan.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1491-5.
BACKGROUND/AIMS: Radiofrequency ablation (RFA) is a new modality for hepatocellular carcinoma (HCC). However, the effects of RFA on hepatic reserve have not yet been thoroughly studied. In the present study, it was evaluated the effect of branched chain amino acid (BCAA) administration after RFA.
Fifty-seven patients with initial, single HCC lesions measuring not more than 30mm in whom RFA was selected in first-line therapy were enrolled. Twenty-eight patients with the Child-Pugh B/C grade who received RFA therapy were divided into two groups: 11 who received a BCAA-enriched nutrient mixture, and 17 who did not. Changes in serum albumin were evaluated before RFA and 1, 6 and 12 months after RFA.
Multivariate analysis showed that the Child-Pugh grading is the most important factor related to intrahepatic distant recurrence following by RFA. Serum albumin levels decreased 1 month after RFA. Although a tendency toward recovery was noted 6 months after RFA, a decreasing tendency was noted again one year after RFA compared to the pre-RFA baseline. However, a tendency toward improvement was noted in Child-Pugh B grade patients who received BCAA mixture.
BCAA mixture made it possible to maintain serum albumin levels and hepatic reserve.
背景/目的:射频消融(RFA)是肝细胞癌(HCC)的一种新治疗方式。然而,RFA对肝脏储备功能的影响尚未得到充分研究。在本研究中,评估了RFA后给予支链氨基酸(BCAA)的效果。
纳入57例初始为单个HCC病灶且病灶直径不超过30mm、一线治疗选择RFA的患者。28例接受RFA治疗的Child-Pugh B/C级患者被分为两组:11例接受富含BCAA的营养混合物,17例未接受。在RFA前以及RFA后1、6和12个月评估血清白蛋白的变化。
多因素分析表明,Child-Pugh分级是RFA后肝内远处复发的最重要相关因素。RFA后1个月血清白蛋白水平下降。尽管RFA后6个月有恢复趋势,但与RFA前基线相比,RFA后1年又出现下降趋势。然而,接受BCAA混合物的Child-Pugh B级患者有改善趋势。
BCAA混合物能够维持血清白蛋白水平和肝脏储备功能。