抗病毒治疗对乙型肝炎相关原发性肝癌患者生活质量及预后的影响  

Antiviral treatment's influence on life quality of patients with HBV-related primary liver cancer

作　　者：郭宏华[1] 晁阳[1] 李岩[1] 王江滨[1] 

机构地区：[1]吉林大学中日联谊医院消化内科,长春130033

出　　处：《肝脏》2012年第2期83-86,共4页Chinese Hepatology

基　　金：吉林省科技厅资助项目(2100742)

摘　　要：目的探讨抗病毒治疗对乙型肝炎相关原发性肝癌患者生活质量的影响。方法选择95例诊断为乙型肝炎相关性原发性肝癌且无手术治疗指征的患者,分为抗病毒联合介入治疗组22例、介人治疗组26例、抗病毒治疗组23例、常规治疗组24例。随访监测治疗后4、12、24及48周肝功能、腹部彩色超声或肝脏CT,每4周对患者生活质量包括食欲、体质量(排除腹水影响因素)及乏力情况进行现场或电话随访,所有患者随访4周至48周。统计学处理采用t检验和x^2检验。结果抗病毒联合介入治疗组、介入治疗组、抗病毒治疗组与常规治疗组患者24周生存率分别为86.4%(19例)、73.1%(19例)、73.9%(17例)、54.2%(13例),48周生存率分别为68.2%(15例)、46.2%(8例)、47.8%(11例)、16.7%(4例)。抗病毒联合介入治疗组、介入治疗组及抗病毒治疗组患者1年生存率明显高于常规治疗组(P<0.05)。抗病毒联合介入治疗组、介入治疗组及抗病毒治疗组患者12周内生活质量较常规治疗组明显改善,其中抗病毒联合介入治疗组改善最明显,其次为介人治疗组与抗病毒治疗组,常规治疗组在生活质量方面无明显改善。治疗24周后抗病毒联合介入治疗组及介入治疗组的肿瘤大小未明显增大,而常规治疗组患者的肿瘤较抗病毒治疗组增大明显。结论在介入治疗及常规治疗的基础上联合抗病毒治疗可提高乙型肝炎相关原发性肝癌患者1年生存率、改善生活质量、延缓肿瘤生长。Objective To evaluate antiviral treatment＇s influence on life quality of patients with HBV-related primary liver cancer （PLC）. Methods 95 cases of primary liver cancer caused by hepatitis B without indications for surgery were divided into 4 different groups： antiviral and interventional therapy group, intervention group, antiviral treatment group, conventional treatment group. Monitor liver function, abdominal ultrasonography or liver computed tomography in the 4th, 12th, 24th and 48th week after treatment. Follow the patients＇ quality of life, including appetite, weight （rule out ascites） by phone or on site every 4 weeks. All patients were followed up for 4 to 48 weeks. Results The survival rates of antiviral combined with and interventional therapy group, interventional therapy group, antiviral treatment group and conventional treatment group were respectively 86.4 %, 73.1%, 73.9% and 54.2% in the 24th week and 68.2% ,46.2%, 47.8% and 16.7% in the 48th week. Antiviral and interventional therapy group, interventional therapy group, antiviral treatment group had a higher one-year survival rate than conventional treatment group （P〈0.05）, and the three groups＇ patients＇ quality of life improved significantly in 12 weeks as compared with conventional treatment group, in which antiviral and interventional therapy group had the most obvious effect, followed by interventional therapy group, antiviral treatment group, while there was no remarkable improvement in conventional treatment group. After 24 weeks＇ treatment, the tumor size of antiviral and interventional therapy group and interventional therapy group did not increase obviously, but conventional treatment group＇s tumor size grew faster than antiviral treatment group did. Conclusion Based on interventional therapy and conventional therapy, antiviral treatment can improve quality of life and one-year survival rate of patients with hepatitis B virus-primary liver cancer and postpone the growth of tumor.

关 键 词：抗病毒 介入 肝细胞癌 乙型肝炎 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]