Study On The Change Of Viral Load And Liver Function In Perioperative Phase For Hepatocellular Carcinoma And Potral Hypetrension Patients

Objectives:1、Discuss the changes of HBV-DNA affected by surgery andsurgical intervention for hepatocellular carcinoma patients and livercirrhosis patients with portal hypertension.2、Discuss the relationship between HBV-DNA level and thechanges of liver function for HBV related hepatocellular carcinomapatients and liver cirrhosis patients with portal hypertension.Methods:1、During August2012to March2013, I selected hepatocellularcarcinoma patients and liver cirrhosis patients with portal hypertensionfrom our department and provided them the corresponding processing ofthe design.2、According to the inclusion criteria, I selected30cases of HBVrelated hepatocellular carcinoma patients who were operated by livercancer resection and23cases of HBV related liver cirrhosis patients withportal hypertension who were operated by SED (splenectomy andesophagogastric devascularization). Testing the preoperative serumHBV-DNA level and the seventh day HBV-DNA level after operation forthese two groups of patients. Testing the preoperative serum liverfunction and the first day, third day, seventh day liver function afteroperation. Observing the recovery time of liver function. 3、According to the viral load levels, patients can be divided intofour groups：negative group、low-replication group、middle-replicationgroup and high-replication group. So as to compare the viral loadchanges between hepatocellular carcinoma (HCC) group and portalhypertension (PH) group.4、Recording the recovery of patients’ liver function between HCCgroup and PH group and analyze the correlation between the viral loadlevels and liver function changes.Results:1、Patients of hepatocellular carcinoma and portal hypertensionwhich is related with hepatitis b, the viral load reaches a higher positiverate and the high replication level of viral load still represents asignificant part.2、There existed obvious changes in serum viral load after operationamong HCC patients, the viral load of most patients (56.67%) declined.But there was no statistical sense about the difference(P>0.05). Thereexist obvious difference in viral load of PH group after the surgicaltreatment, the viral load of most patients (65.21%) rised. Meanwhile,HBV was active in replication after surgery and the difference wasstatistically significant (P <0.05).3、Comparing the viral load changes of patients between HCC groupand PH group, there exist obvious difference in viral load changes after surgical treatment. The difference was statistically significant (P <0.05).4、Comparing different serum HBV-DNA level groups, there existsignificant differences in maximum value of ALT and AST after surgery.The higher HBV-DNA level, the higher maximum value of ALT and AST(P <0.05). When patients with high levels of viral load, the recoverytime of liver function significantly prolonged (P <0.05).Conclusions：1、The virus is still active in the body of patients with chronic liverdisease, we should strengthen the monitoring of viral load and adoptpersonalized antiviral treatment.2、There exist a certain relationship between liver function changesand the replication levels of virus for patients with chronic liver disease,patients with high levels of viral replication will significantly prolong therecovery time of liver function.3、Liver cancer resection will reduce the level of viral load to acertain extent in perioperative phase, SED will stimulate HBV to activereplication. Surgery will have great influence on virus active degree. Weshould pay attention to monitor the viral load level and provide patientsantiviral treatment in perioperative phase.