| 靳远1，齐劲松2，刘保清1，解娜3▲.肝细胞癌患者TACE治疗后新发心血管疾病的危险因素分析[J].中国医药科学,2024,14(10):111-114 基金项目:新乡医学院第三附属医院开放课题 （KFKTYB202123） |
| 肝细胞癌患者TACE治疗后新发心血管疾病的危险因素分析 |
| Analysis of risk factors of new cardiovascular disease in patients with hepatocellular carcinoma after TACE treatment |
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| DOI： |
| 中文关键词: 肝细胞癌；经导管动脉化疗栓塞；心血管疾病；危险因素 |
| 英文关键词:Hepatocellular carcinoma; Transcatheter arterial chemoembolization; Cardiovascular diseases; Risk factor |
| 作者 | 单位 | | 靳远1，齐劲松2，刘保清1，解娜3▲ | 1. 新乡医学院第三附属医院介入科，河南新乡 453000；2. 新乡医学院第一附属医院介入科， 河南卫辉 453100；3. 新乡医学院第三附属医院心脏重症监护室，河南新乡 453000 |
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| 中文摘要: |
| [摘要]目的 探讨经导管动脉化疗栓塞（TACE）治疗后肝细胞癌患者 6 个月内发生心血管疾病的危险因素。 方法 回顾性分析 2020 年 5 月 1 日至 2023 年 6 月 30 日在新乡医学院第一附属医院接受 TACE 治疗的 155 例 肝细胞癌患者的临床数据。排除不完整资料及失访患者后，纳入 105 例患者进行分析。根据患者 TACE 治疗后 是否发生心血管疾病分为两组，通过多因素分析确定独立危险因素。结果 105 例肝细胞癌患者共有 29 例在 6 个 月内发生心血管疾病，占比 27.6%。随访发现，29 例患者均出现不同程度的心律失常。另外，这些心律失常的 患者有 8 例在 TACE 治疗后第 2 ～ 8 周出现心绞痛，5 例在第 3 ～ 12 周发生心力衰竭，3 例在第 13 ～ 24 周发 生心肌炎，2 例在第 2 周发生急性心肌梗死，占心血管疾病总例数的 62.1%。独立危险因素包括肝功能 B 级、糖 尿病、高脂血症、TACE 治疗次数超过 3 次及未规律运动（OR > 1 且 P < 0.05）。多因素联合预测的受试者工作 特征曲线下面积值为 0.782（95%CI：0.683 ～ 0.882），显示出良好的预测效能。结论 TACE 治疗后肝细胞癌患 者的心血管疾病风险应引起重视。对于存在相关风险因素的患者，应积极控制基础疾病并增加体力活动。 |
| 英文摘要: |
| [Abstract] Objective To explore the risk factors of cardiovascular diseases in patients with hepatocellular carcinoma within 6 months after transcatheter arterial chemoembolization (TACE). Methods The clinical data of 155 hepatocellular carcinoma patients treated with TACE in the First Affiliated Hospital of Xinxiang Medical University from May 1, 2020 to June 30, 2023 were analyzed retrospectively. After the exclusion of incomplete data and lost patients, a total of 105 patients were included for analysis. Patients were divided into two groups according to whether cardiovascular disease occurred after TACE treatment, and independent risk factors were determined by multivariate analysis. Results Among the 105 hepatocellular carcinoma patients, 29 (27.6%) developed cardiovascular disease within six months. Follow-up revealed that 29 patients developed various degrees of arrhythmias. In addition, 8 of these patients with arrhythmias developed angina pectoris between weeks 2 and 8 after TACE, 5 patients developed heart failure between weeks 3 and 12, 3 patients developed myocarditis between weeks 13 and 24, and 2 patients developed acute myocardial infarction at week 2, accounting for 62.1% of total cardiovascular disease cases. Independent risk factors included liver function grade B, diabetes, hyperlipidemia, TACE treatment for more than 3 times and irregular exercise (OR > 1 and P < 0.05). The area under the curve value of the receiver operating characteristic predicted by multi-factors was 0.782 (95%CI: 0.683-0.882), which showed good prediction efficiency. Conclusion The risk of cardiovascular disease in patients with hepatocellular carcinoma after TACE should be paid attention. For patients with related risk factors, we should actively control the basic diseases and
increase physical activity. |
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