多柔比星和碘化油对原发性肝癌患者的疗效及血清TK1、AFP及VEGF水平的影响  

Effect of Doxorubicin and Lipiodol on the Level of Serum TK1,AFP and VEGF in Patients with Primary Liver Cancer

作　　者：李珍艳 杨小莉[1] 李罗红[1] 李小琼[1] 欧艳[1] 陈莎[1] 雷娜[1] Li Yanzhen;Yang Xiaoli;Li Luohong(West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院消化内科,四川成都610041

出　　处：《四川医学》2018年第10期1186-1190,共5页Sichuan Medical Journal

摘　　要：目的探讨原发性肝癌患者采用多柔比星和碘化油实施肝动脉灌注化疗栓塞(TACE)治疗的临床效果。方法选取我院肿瘤科实施TACE治疗的90例原发性肝癌患者,收集时间2013年1月至2017年1月,其中45例患者采用多柔比星和碘化油(联合组)、另外45例患者采用氟尿嘧啶治疗(对照组),对比两组的临床疗效、血清胸苷激酶(TK1)、甲胎蛋白(AFP)、血管内皮生长因子(VEGF)的变化及远期生存率。结果联合组患者的缓解率82.22%高于对照组的60.00%,差异有统计学意义(P<0.05);联合组患者的总有效率95.56%,与对照组88.89%相比差异无统计学意义(P>0.05)。治疗前,两组患者的血清TK1、AFP、VEGF水平差异无统计学意义差异无统计学意义(P>0.05);治疗后,联合组患者的血清TK1、AFP、VEGF水平显著低于对照组,两组患者的血清TK1、AFP、VEGF水平较治疗前均显著的降低,差异有统计学意义(P<0.05);联合组和对照组患者的腹泻、脱发、皮疹、肝功能损害、肾功能损害发生率差异无统计学意义(P>0.05);联合组患者的恶心呕吐、骨髓抑制的发生率显著的高于对照组患者,差异有统计学意义(P<0.05);联合组和对照组患者的失访率差异无统计学意义(P>0.05);联合组患者的3年生存率22.22%高于对照组的8.89%,差异无统计学意义(P>0.05)。结论原发性肝癌患者采用多柔比星和碘化油实施TACE治疗较单用奥沙利铂具有更好的效果,但是毒副反应会加重,因此治疗过程中应密切关注。Objective To investigate the clinical effect of transcatheter arterial chemoembolization(TACE)with doxorubicin and lipiodol in the treatment of primary liver cancer.Methods Selected the hospital implementation of TACE treatment of 90 cases of primary liver cancer patients were collected from January 2013 to January 2017,the time,of which 45 cases were treated with doxorubicin and iodized oil(combined group),another 45 patients were treated with fluorouracil(control group),to compare the clinical efficacy of two groups of serum thymidine kinase(TK1),alpha fetoprotein(AFP)and vascular endothelial growth factor(VEGF)changes and long-term survival rate.Results Combined with the remission rate of patients was higher than 82.22%in control group 60%(P<0.05),efficiency of 95.56%higher than the control group in the total 88.89%patients in the combination group,but the difference was not statistically significant(P>0.05);before treatment,two groups of patients with serum TK1,AFP and VEGF levels had no significant difference(P>0.05)after treatment;patients in the combination group,serum TK1,AFP and VEGF were significantly lower than the control group(P<0.05 group),two patients with serum TK1,AFP and VEGF levels before treatment were significantly decreased(P<0.05);combination group and control group patients with diarrhea,hair loss,skin rash,liver damage,kidney function damage rate there was no statistically significant difference(P<0.05);a group of patients with nausea and vomiting,the incidence of myelosuppression was significantly higher than control group(P<0.05);combination group and control group patients lost to follow-up rate statistics The study significance(P>0.05);the 3 year survival rate of the patients in the combined group was 22.22%higher than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion TACE with doxorubicin and iodized oil is more effective than oxaliplatin alone in the treatment of primary hepatocellular carcinoma,but the side effects will be aggravated,

关 键 词：原发性肝癌 多柔比星 碘化油 肝动脉灌注化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]