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骨骼肌指数对经动脉化疗栓塞后肝细胞癌栓塞后综合征的影响。

Effect of skeletal muscle index on post-embolization syndrome of hepatocellular carcinoma after transarterial chemoembolization.

机构信息

Hebei Provincial Key Laboratory of Portal Hypertension and Cirrhosis, Xingtai People's Hospital, Xingtai, Hebei, 054001, China.

Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

出版信息

BMC Gastroenterol. 2024 Sep 30;24(1):333. doi: 10.1186/s12876-024-03427-0.

Abstract

BACKGROUND

Skeletal muscle index (SMI) is a commonly used research method for evaluating muscle mass.However, its impact on post-embolization syndrome(PES) of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is unclear.Our objective was to determine the effect of SMI on PES after TACE in patients with HCC.

METHODS

We conducted a retrospective analysis of patients who received TACE treatment for HCC at our hospital from 2015 to 2020. The subjects were divided into two groups according to the presence or absence of PES after TACE, and their clinical characteristics were compared.SMI was measured and calculated by cross-sectionally at the level of the third lumbar vertebra based on computed tomography (CT). According to the cutoff value, the patients were classified into either low or high SMI group.Potential risk factors for PES were assessed using univariate and multivariable Cox proportional risk models.

RESULTS

A total of 110 people were included in this study, from which including 82 patients experienced PES. Serum albumin was significantly lower in the PES group compared to the non-PES group.The frequency of HCC with a maximum diameter > 3 cm and low SMI in the PES group was significantly higher than in patients without PES. Cox multivariate analysis identified that the maximum diameter of HCC > 3 cm and low SMI were independent predictors of PES after TACE.

CONCLUSIONS

Low SMI is an independent predictor of PES in HCC patients after TACE treatment, making preoperative CT assessment of skeletal muscle mass is a simple and effective tool for predicting PES.

摘要

背景

骨骼肌指数(SMI)是评估肌肉量的常用研究方法。然而,其对接受经动脉化疗栓塞术(TACE)治疗的肝细胞癌(HCC)患者的栓塞后综合征(PES)的影响尚不清楚。我们的目的是确定 SMI 对 HCC 患者 TACE 后 PES 的影响。

方法

我们对 2015 年至 2020 年在我院接受 TACE 治疗的 HCC 患者进行了回顾性分析。根据 TACE 后是否发生 PES,将患者分为两组,并比较其临床特征。SMI 通过 CT 横断位在第三腰椎水平进行测量和计算。根据截断值,将患者分为低 SMI 组或高 SMI 组。使用单变量和多变量 Cox 比例风险模型评估 PES 的潜在危险因素。

结果

本研究共纳入 110 人,其中 82 人发生 PES。与非 PES 组相比,PES 组的血清白蛋白显著降低。在 PES 组中,HCC 最大直径>3cm 和低 SMI 的发生率明显高于无 PES 组。Cox 多变量分析确定 HCC 最大直径>3cm 和低 SMI 是 TACE 后 PES 的独立预测因素。

结论

低 SMI 是 HCC 患者 TACE 治疗后 PES 的独立预测因素,提示术前 CT 评估骨骼肌量是预测 PES 的一种简单有效的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c71e/11441167/441c7e9f898d/12876_2024_3427_Fig1_HTML.jpg

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