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目的探讨肝动脉化疗栓塞术(TACE)联合拉米夫定与TACE联合拉米夫定+阿德福韦酯治疗乙型肝炎病毒(HBV)相关肝癌患者疗效及预后影响。方法 106例原发性肝癌患者,随机分为A组48例和B组58例。所有患者均反复行TACE治疗,A组初治使用拉米夫定,B组初治使用拉米夫定+阿德福韦酯,分析两组抗病毒疗效、病毒耐药情况、患者生存期。结果两组患者术前及术后1.5~3.0个月肝功能Child评分、ALT、AST、HBV-DNA阴转率差异无统计学意义(P>0.05);两组病例0.5、1、1.5、2、3年发生病毒耐药率、术后3年生存率比较差异有统计学意义(P<0.05)。结论对于HBV相关性肝癌患者,在进行TACE治疗时,应优先选择拉米夫定联合阿德福韦酯的抗病毒治疗方案,具有一定应用参考价值。
Objective To investigate the curative effect and prognosis of patients with hepatocellular carcinoma associated with Hepatitis B virus (HBV) treated by transcatheter arterial chemoembolization (TACE) combined with lamivudine and TACE in combination with lamivudine and adefovir dipivoxil. Methods 106 patients with primary liver cancer were randomly divided into group A 48 cases and group B 58 cases. All patients were repeatedly treated with TACE, group A was treated with lamivudine, and group B was treated with lamivudine plus adefovir dipivoxil. The anti-virus efficacy, virus resistance and patient survival were analyzed. Results There was no significant difference in Child function score, ALT, AST, HBV-DNA negative conversion rate between the two groups before and 1.5 to 3.0 months after operation (P> 0.05). The two groups of patients were 0.5,1,1.5,2 , 3 years after the occurrence of virus resistance rate, 3-year survival rate after the difference was statistically significant (P <0.05). Conclusion For patients with HBV-related hepatocellular carcinoma, antiviral treatment of lamivudine combined with adefovir dipivoxil should be given priority in TACE treatment, which may be of some application value.