论文部分内容阅读
目的探讨经导管肝动脉化疗栓塞术(TACE)联合鸦胆子油乳剂治疗肝癌患者的临床疗效及对血浆内毒素、血管内皮生长因子(VEGF)水平的影响。方法选取2013年1月至2014年1月新疆喀什地区第二人民医院收治的肝癌患者126例,采用随机数字表法将其分为TACE联合鸦胆子油乳剂组(观察组)及单用TACE组(常规组),每组各63例患者。所有患者治疗至少3个疗程并随访6~37个月。比较两组患者治疗后的临床疗效、不良反应发生率、中位疾病进展时间(TTP)及总存活率,同时比较治疗前后肝功能指标、血浆内毒素及VEGF的水平。结果观察组的治疗总有效率及中位TTP显著高于常规组(P<0.01)。治疗后,观察组的不良反应发生率显著低于常规组(P<0.01);两组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清胆红素(TBIL)、血浆内毒素及VEGF的水平均升高,但观察组显著低于常规组(P<0.01)。两组1、2、3年的总存活率比较,差异均无统计学意义(P>0.05)。结论鸦胆子油乳剂辅助TACE治疗肝癌,可改善患者的近期疗效和肝功能,延长TPP时间,降低血浆内毒素、VEGF的水平,是治疗肝癌安全有效的方法。
Objective To investigate the clinical efficacy of transcatheter hepatic arterial chemoembolization (TACE) combined with Brucea javanica oil emulsion in the treatment of hepatocellular carcinoma (HCC) and its effect on plasma endotoxin and vascular endothelial growth factor (VEGF) levels. Methods A total of 126 HCC patients admitted to the Second People’s Hospital of Kashgar District in Xinjiang from January 2013 to January 2014 were selected and randomized into the TACE combined with Brucea oil emulsion group (observation group) and TACE alone group. (Conventional group), 63 patients in each group. All patients were treated for at least 3 courses and followed up for 6 to 37 months. The clinical efficacy, incidence of adverse reactions, median progression time (TTP), and overall survival rate after treatment were compared between the two groups of patients. The liver function indexes, plasma endotoxin and VEGF levels were compared before and after treatment. Results The total effective rate of treatment and median TTP were significantly higher in the observation group than in the conventional group (P<0.01). After treatment, the incidence of adverse reactions was significantly lower in the observation group than in the conventional group (P<0.01); alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum bilirubin (TBIL) in both groups. Plasma levels of endotoxin and VEGF increased, but the observation group was significantly lower than the conventional group (P<0.01). There was no significant difference in the overall survival rate between the two groups at 1, 2 and 3 years (P>0.05). Conclusion Brucea javanica oil emulsion assisted TACE treatment of liver cancer can improve the short-term efficacy and liver function of patients, prolong TPP time, reduce plasma endotoxin and VEGF levels. It is a safe and effective method for the treatment of liver cancer.