国内应用TACE联合核苷类抗病毒药物治疗中晚期肝癌疗效的系统评价  

TACE Combined with Nucleoside Antiviral Drugs for the Treatment of Advanced Hepatic Carcinoma in China:A Systematic Review

作　　者：李宏[1] 李子林[1] 朱能[1] 翁高龙[1] 王洪波[1] 张新华[1] 

机构地区：[1]湖北省肿瘤医院肝胆胰外科,武汉430079

出　　处：《华中科技大学学报（医学版）》2016年第4期458-463,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的通过Meta分析的方法对国内应用TACE联合核苷类抗病毒药物治疗中晚期肝癌的疗效进行系统评价。方法计算机检索维普科技期刊数据库（1989-2015）、万方数据库（1999-2015）、中国知网数据库（1994-2015）、学术期刊网络出版总库等数据库中关于TACE联合核苷类抗病毒药物治疗中晚期肝癌疗效的临床随机对照试验（RCT）,对符合要求的RCT进行Meta分析。结果最终纳入24篇RCT,共有2 085例患者符合纳入标准。Meta分析结果显示：较TACE治疗组,TACE联合抗病毒治疗组的临床有效率高[总效应Z=4.95,OR=1.83,95%CI（1.44,2.32）,P〈0.01],1年生存率高[总效应Z=8.54,OR=2.86,95%CI（2.25,3.64）,P〈0.01],Child-Pugh评分低[总效应Z=8.64,MD=-0.84,95%CI（-1.03,-0.65）,P〈0.01],ALT水平低[总效应Z=5.99,MD=-23.27,95%CI（-30.88,-15.65）,P〈0.01],并发症及不良反应并没有增加[总效应Z=0.31,OR=1.30,95%CI（0.25,6.71）,P=0.76]。结论较TACE治疗,TACE联合核苷类药物抗病毒治疗中晚期肝癌能提高临床有效率及患者生存率,改善肝功能,而并发症及不良反应并没有增加。Objective To examine the efficacy of transhepatic arterial chemotherapy and embolization（TACE）in combination with nucleoside antiviral drugs in the treatment of advanced hepatic carcinoma in China by means of the meta-analysis.Methods A comprehensive search was performed in VIP（1989-2015）,WANFANG（1999-2015）,CNKI（1994-2015）and CAJD databases to obtain the randomized controlled trials（RCT）which examined the treatment of advanced hepatic carcinoma with TACE combined with nucleoside antiviral drugs.RTCs that met the inclusion criteria were subjected to a meta-analysis.Results A total of 24 RCTs,involving 2 085 patients,were eventually included for the meta-analysis.The results showed that the clinical effective rate was higher in combination group than in TACE group[overall effect：Z=4.95,OR=1.83,95%CI（1.44,2.32）,P〈0.01].The combination group had higher 1-year survival rate[overall effect：Z=8.54,OR=2.86,95%CI（2.25,3.64）,P〈0.01],lower Child-Pugh score[overall effect：Z=8.64,MD=-0.84,95%CI（-1.03,-0.65）,P〈0.01]and lower ALT level[overall effect：Z=5.99,MD=-23.27,95%CI（-30.88,-15.65）,P〈0.01]than the TACE group did.The complications and adverse reactions didn＇t increase in the combination group[overall effect：Z=0.31,OR=1.30,95%CI（0.25,6.71）,P=0.76].Conclusion TACE in combination with nucleoside antiviral drugs can increase the clinical effective rate and survival rate,and improve the liver function,without increasing the adverse reactions.

关 键 词：肝癌 TACE 疗效 抗病毒治疗 META分析 

分 类 号：R735.7[医药卫生—肿瘤]