The Effect Of Magnesium Isoglycyrrhizinate In Different Doses On The Liver Function Of The Patients With Primary Hepatic Carcinoma Post Transcatheter Arterial Chemoembolization

Objective: Primary hepatic carcinoma(PHC) was one of the mostcommon cancers in the world, with the gradually increased incidence andmortality. Most patients absence of specific symptoms at early stage had lostthe opportunity of surgical therapy when PHC was diagnosed at advancedstage. The transcatheter arterial chemoembolization (TACE) was showed toincrease the overall survival of patients significantly, but the liver injury postTACE limited further therapy. The magnesium isoglycyrrhetate (MgIG) hadbeen found to be a protective effect on acute and chronic liver injury. However,there was little reports about the different doses of MgIG in protecting liverfunction of patients with TACE. In this study, the effects of MgIG indifferent doses on liver function of patients were observed, meantime theeffects between simple embolization and combined infusion chemotherapy onliver function were compared, which would be helpful to the therapy ofpatients with advanced primary hepatic carcinoma.Methods: Two hundred and fifty-five patients with PHC who underwentTACE were enrolled in the Forth Hospital of Hebei University from January,2007to December,2013, including30females and225males with averageage being58.9±10.9years,94patients performed simple embolization and161patients performed combined infusion chemotherapy. According todifferent doses and kinds of medicines, all patients were divided into3groups:group A (including94cases), group B(including86cases) and group C(including75cases).The patients of group A were infused with glutathione1.2g/d for3dayspost TACE, the group B were infused with MgIG100mg/d, and the group Cwere infused with MgIG200mg/d. The other therapeutic methods were the same in3groups. The blood samples were collected from patients before andthree days after TACE, and the liver function such as ALT, AST, TBIL, DBIL,ALP, GGT, CHE were measured. The level of statistical significance was setup at P＜0.05, and all calculations were carried out using the SPSS17.0software.Results:1As for the Age, Gender, Child-Pugh grading, Portal vein tumorthrombosis, Arteriovenous fistula, and Ascites, there were no statisticaldifferences in three groups（P>0.05）.2The effect of different doses and kinds of medicines on liver functionbetween pre-TACE and post TACEThe effects on liver function in3groups were assessed through thedifference of liver function between pre-TACE and post TACE, the larger thedifference, the weaker of protection on liver function. The difference of theALT[14U/L] in group C was lower than group B[26U/L] and groupA[43.5U/L](P<0.05), and so as the AST in group C[11U/L], group B[25U/L],and group A[39U/L](P<0.05); Simultaneously the difference of theALP[-7U/L] in group C was less than group A[-2U/L](P<0.05). As for theTBIL, DBIL, GGT, there were no statistical differences in3groups. Thehigher dose of magnesium isoglycyrrhetate had advantage in protecting theliver cell membrane and preventing the liver injury, but no advantage inmaintaining the liver reserve function and regulating the metabolism ofbilirubin.3The effect of simple embolization and combined infusionchemotherapy on liver functionThe different effects on liver function between simple embolization andcombined infusion chemotherapy were assessed through the difference of liverfunction between pre-TACE and post TACE. The difference ofALT[42.69±71.33U/L] in combined infusion chemotherapy group was lowerthan the simple embolization group[88.48±135.29U/L], and so as the AST incombined infusion chemotherapy group(38.07±71.99U/L) and simple embolization[71.38±108.01U/L](P<0.05). As for the TBIL, DBIL, ALP, GGT,CHE, there were no statistical differences between the two therapeuticmethods.27Child-Pugh B cases[28.72%] and23ascites cases[24.47%] wereenrolled in simple embolization,28Child-Pugh B cases[17.39%] and23ascites cases[14.29%] were enrolled in combined infusion chemotherapy,more Child-Pugh B cases and ascites cases were enrolled in simpleembolization(P<0.05）. As for the Age, Portal vein tumor thrombosis,Arteriovenous fistula, there were no statistical differences between simpleembolization and combined infusion chemotherapy（P>0.05）.Conclusion:1Higher dose of magnesium isoglycyrrhetate was superior to lower dosein protecting the liver cell and preventing the liver injury, and not inmaintaining the liver reserve function and regulating the metabolism ofbilirubin.2As for primary hepatic carcinoma patients, either simple embolizationor combined infusion chemotherapy could injury the liver cell, how tochoose suitable methods to different patients remained further research.