肝动脉化疗栓塞术在艾滋病合并肝癌患者中的应用价值  

The clinical applications of transcatheter arterial chemoembolization(TACE)in treating AIDS patients complicated with primary liver cancer

作　　者：周粟[1] 袁敏[1] 施裕新[1] 顾宇国 王峻峰[1] 杨柏帅[1] 李清涛[1] 

机构地区：[1]复旦大学附属公共卫生临床中心医学影像科介入科,上海201508

出　　处：《放射学实践》2015年第9期918-921,共4页Radiologic Practice

摘　　要：目的:探讨肝动脉化疗栓塞术(TACE)在艾滋病合并肝癌患者中的应用价值。方法:回顾性分析9例艾滋病合并肝癌患者(研究组)及35例普通肝癌患者(对照组)的临床及影像资料,分析TACE术前、术后肝功能指标(ALT、TBIL)、细胞免疫指标及AFP值的变化情况,并采用mRECIST标准对肿瘤近期疗效进行评价。结果:研究组TACE术后1周肝功能指标(ALT、TBIL)较术前明显升高(P<0.05),术后1个月恢复至术前水平(P>0.05),与对照组变化一致;研究组TACE术后1个月CD4+、CD4+/CD8+水平与术前差异无统计学意义(P>0.05),与对照组变化一致;研究组TACE术后1个月肿瘤疗效与对照组差异无统计学意义(P>0.05)。结论:肝动脉化疗栓塞术对艾滋病合并肝癌患者是安全、有效的治疗方法。但由于艾滋病患者的特殊性,术前应根据患者机体免疫状况行高效抗逆转录疗法及抗微生物治疗预防真菌等机遇性感染,严格掌握TACE适应证,术中采用低于常规剂量的化疗药物。Objective：The purpose of this study was to investigate the clinical application value of transcatheter arteri-al chemoembolization （TACE）in treating primary liver cancer （PLC）in patients with AIDS.Methods：A total of 44 patients with PLC treated with TACE were divided into study group （n=9,AIDS）and control group （n=35,Non-AIDS）.The liver function,T lymphocyte subsets and changes of AFP level of PLC patients were analyzed before and after the treatments. The therapeutic effectiveness was assessed by use of mRECIST within one month after the treatment,which was based on contrast CT or MR results.Results：In the study group,ALT and TBIL levels were increased in one week after TACE （P ＆lt;0.05）,and ALT and TBIL levels were decreased in one month after TACE （P ＆gt;0.05）.There was no significant difference in CD4＋T lymphocyte and CD4＋/CD8＋ between the data before and one month after TACE （P ＆gt;0.05）.Also the results about therapeutic effectiveness showed no significant differences between study and control group （P ＆gt;0.05）.Conclusion：TACE can be a safe and effective procedure in treating primary liver cancer （PLC）in patients with AIDS.No significant differences were observed on the changes of liver function,cellular immunity indices and therapeutic effectiveness between the two groups according to our data.However,due to its particularity,the patients should be treated by highly active an-tiretroviral therapy （HARRT）and anti microorganism treatment to prevent opportunistic infections according to the pa-tients＆#39;immune status before TACE.The indications for TACE should be reviewed strictly before decisions are made,and the doses of chemotherapy during TACE procedures should be lower than regular ones.

关 键 词：获得性免疫缺陷综合征 肝肿瘤 经导管动脉化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤] R512.91[医药卫生—临床医学] R730.44