阿帕替尼对中晚期肝癌患者经导管动脉化疗栓塞术后肝功能及血管生成因子的影响  

Effect of apatinib on liver function and angiogenic factors after transcatheter arterial chemoembolization in patients with intermediate to advanced hepatocellular carcinoma

作　　者：连芬 王美娥 龚思思 范春梅[1] 李承宗[2] LIAN Fen;WANG Mei-e;GONG Si-si;FAN Chun-mei;LI Cheng-zong(Department of Laboratory,Department of Laboratory,Second Affiliated Hospital,Fujian Medical University,Quanzhou 362000,Fujian Province,China;Department of Hepatological Surgery,Department of Laboratory,Second Affiliated Hospital,Fujian Medical University,Quanzhou 362000,Fujian Province,China)

机构地区：[1]福建医科大学附属第二医院检验科,福建泉州362000 [2]福建医科大学附属第二医院肝胆外科,福建泉州362000

出　　处：《中国临床药理学杂志》2023年第10期1402-1406,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察阿帕替尼对中晚期肝癌患者经导管动脉化疗栓塞(TACE)术后肝功能及血管生成因子的影响。方法将中晚期肝癌患者根据治疗方法分为对照组和试验组。对照组采用TACE术进行治疗,患者局部麻醉后进行股动脉穿刺插管,明确肿瘤组织的供血动脉后插管并注入盐酸表柔比星20~40 mg、5-氟尿嘧啶750 mg、碘化油10~20 mL后以明胶海绵栓塞,每4周1次;试验组在对照组的基础上,于首次TACE术治疗后72 h开始口服阿帕替尼,每次850 mg,每天1次。2组患者接受治疗12周。比较2组患者的临床疗效、血清肝功能指标、肿瘤标志物、血管生成相关细胞因子表达差异及药物不良反应发生情况。结果对照组和试验组各65例。治疗后,试验组的总有效率为73.85%,显著高于对照组(53.85%),差异有统计学意义(P<0.05)。治疗后,试验组和对照组血清谷丙转氨酶(GPT)、血清谷草转氨酶(GOT)、血清白蛋白(Alb)水平差异均无统计学意义(均P>0.05)。治疗后,试验组和对照组血清甲胎蛋白(AFP)水平分别为(147.03±18.65)和(275.48±29.85)ng·mL^(-1),血清癌胚抗原(CEA)水平分别为(17.49±2.63)和(24.96±3.64)ng·mL^(-1),血清α-L-岩藻糖苷酶(AFU)水平分别为(57.63±6.99)和(69.48±7.22)U·L^(-1),血清E-钙黏蛋白(EC)水平分别为(1798.75±189.69)和(2207.54±218.75)ng·mL^(-1),血清血管内皮生长因子(VEGF)水平分别为(128.75±17.55)和(169.74±19.83)ng·L^(-1),血清结缔组织生长因子(CTGF)水平分别为(1399.76±195.74)和(1589.89±209.94)ng·L^(-1),血清缺氧诱导因子-1α(HIF-1α)水平分别为(56.30±5.74)和(63.30±6.74)ng·L^(-1),血清基质金属蛋白酶-9(MMP-9)水平分别为(986.95±101.57)和(1362.96±175.97)ng·L^(-1),差异均有统计学意义(均P<0.05)。对照组和试验组的中位生存期(mOS)分别为13.5和18.4个月,中位无疾病进展生存期(mPFS)分别为5.3和11.4个月,差异均有统计学意义(均P<0.05)。治疗期间,试验组腹痛腹泻Objective To analyze the effects of apatinib on liver function and angiogenic factors after transcatheter arterial chemoembolization(TACE)in patients with intermediate to advanced hepatocellular carcinoma.Methods Patients with intermediate to advanced hepatocellular carcinoma were divided into control group and treatment group according to the treatment method.In the control group,the patients were treated by TACE,and the femoral artery was punctured after local anesthesia,and the blood supply artery of the tumor tissue was clarified and then cannulated and injected with epirubicin hydrochloride 20-40 mg,5-fluorouracil 750 mg,iodized oil 10-20 mL,followed by gelatin sponge embolization for 4 weeks.The treatment group was treated with apatinib 850 mg on the basis of the control group,and oral apatinib was given at 72 h after the first TACE treatment,once a day.Patients in the two groups were treatment for 12 weeks.The clinical efficacy of the two groups,and the differences in serum liver function index,tumor markers,expression of angiogenesis-related cytokines and adverse drug reactions between the two groups were compared.Results There were 65 cases in control group and 65 cases in treatment group.After treatment,the total effective rate of treatment group was 73.85%,significantly higher than that of control group,which was 53.85%,and the difference was statistically significant(P<0.05).After treatment,the serum glutamic-pyruvic transaminase(GPT)levels,the serum glutathione aminotransferase(GOT)levels and the serum albumin(Alb)levels were with no statistically significant difference between the two groups(all P>0.05).After treatment,serum alpha-fetoprotein(AFP)levels were(147.03±18.65)and(275.48±29.85)ng·mL^(-1);serum carcinoembryonic antigen(CEA)levels were(17.49±2.63)and(24.96±3.64)ng·mL^(-1);serumα-L-amylase(AFU)levels were(57.63±6.99)and(69.48±7.22)U·L^(-1);serum E-calcineurin(EC)levels were(1798.75±189.69)and(2207.54±218.75)ng·mL^(-1);serum vascular endothelial growth factor(VEGF)levels were(128

关 键 词：肝癌 中晚期 阿帕替尼 经导管动脉化疗栓塞术 肝功能 肿瘤标志物 血管生成因子 

分 类 号：R979.1[医药卫生—药品]