Port Gabriela Zanatta, Oliveira Kalinca, Soldera Jonathan, Tovo Cristiane Valle
Pós Graduação do Curso de Hepatologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
Arq Gastroenterol. 2014 Jan-Mar;51(1):10-5. doi: 10.1590/s0004-28032014000100003.
Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis.
The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging.
Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed.
The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides), protein (albumin, creatinine and uric acid), iron (transferrin, iron and ferritin saturation), hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging.
Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.
患有肝细胞癌的肝硬化患者存在营养改变和代谢紊乱，对预后产生负面影响。
目的是确定患有和未患有肝细胞癌的肝硬化患者中大量营养素和微量营养素代谢的改变，以及它们与Child-Turcote-Pugh评分和巴塞罗那临床肝癌分期的关系。
进行分析性横断面研究，纳入31例肝细胞癌患者和48例肝硬化患者。进行实验室检查。评估生化参数与疾病严重程度以及肝细胞癌存在之间的关联。
丙型肝炎病毒和肝细胞癌导致的肝硬化患者的代谢营养状况显示出改变，特别是脂质（总胆固醇、高密度脂蛋白和甘油三酯）、蛋白质（白蛋白、肌酐和尿酸）、铁（转铁蛋白、铁和铁蛋白饱和度）、血细胞比容和血红蛋白、锌和维生素B12水平。营养生化标志物与Child-Turcote-Pugh评分以及巴塞罗那临床肝癌分期之间存在关联。
考虑到患有和未患有肝细胞癌的肝硬化患者存在营养代谢改变，并且传统营养评估方法对该人群存在局限性，生化实验室检查对于快速、实际地补充营养状况诊断是有效的。
