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目的探索减少经导管动脉化疗栓塞术(TACE)中化疗药剂量对原发性肝癌(PHC)患者肝纤维化指标、血清转化生长因子-β1(TGF-β1)水平及短期疗效的影响。资料与方法 36例不可手术切除的PHC患者接受超选择性TACE,按入选标准随机分为两组,A组(n=15,小剂量组)给予小剂量化疗药物;B组(n=21,常规剂量组)给予常规剂量化疗药物。结果两组患者治疗前后血清学指标比较,常规剂量组术后三项纤维化指标透明质酸(HA)、人Ⅲ型前胶原(hPC-Ⅲ)、Ⅳ-C型胶原(Ⅳ-C)及TGF-β1水平均明显高于手术前(P<0.01),层粘连蛋白(LN)水平较术前升高(P<0.05);小剂量组术后四项肝纤维化指标较术前无显著性差异(P>0.05),TGF-β1水平较术前升高(P<0.05);近期疗效比较两组无显著性差异(P>0.05)。结论 TACE治疗PHC,适当减少化疗药物剂量可减轻肝纤维化的发生,有利于保护肝功能,而并不影响到患者近期疗效。
Objective To explore the effect of reducing the dose of chemotherapy in transcatheter arterial chemoembolization (TACE) on the indexes of liver fibrosis, serum transforming growth factor-β1 (TGF-β1) and short-term efficacy in patients with primary liver cancer (PHC). Materials and Methods 36 cases of PHC patients with unresectable PHC were randomly divided into two groups according to the selection criteria. Group A (n = 15, low dose group) received low dose chemotherapy; group B (n = 21, Conventional dose group) given conventional doses of chemotherapy drugs. Results Before and after treatment, serum fibrinogen (HA), human type Ⅲ procollagen (hPC-Ⅲ), type Ⅳ-C collagen (Ⅳ-C) The levels of TGF-β1 were significantly higher than those before operation (P <0.01), and the laminin (LN) levels were higher than those before operation (P <0.05). There was no significant difference in the four liver fibrosis indexes (P> 0.05). The level of TGF-β1 was higher than that before operation (P <0.05). There was no significant difference between the two groups in the short term efficacy (P> 0.05). Conclusion TACE treatment of PHC, the appropriate dose of chemotherapy drugs can reduce the incidence of liver fibrosis, is conducive to the protection of liver function, but does not affect the patient’s immediate effect.