甲磺酸阿帕替尼治疗晚期原发性肝癌患者的效果及对血清血管内皮生长因子和缺氧诱导因子-1α水平的影响研究  

Study on the Effect of Apatinib Mesylate in the Treatment of Patients with Advanced Primary Hepatocellular Carcinoma and the Effect on Serum Vascular Endothelial Growth Factor and Hypoxia-inducible Factor-1α Levels

作　　者：芦明月 Lu Mingyue(Department of Oncology Section I,Jiamusi Cancer and Tuberculosis Hospital,Jiamusi,Heilongjiang,154007,China)

机构地区：[1]佳木斯市肿瘤结核医院肿瘤一科,黑龙江佳木斯154007

出　　处：《黑龙江医学》2023年第13期1584-1587,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨甲磺酸阿帕替尼治疗晚期原发性肝癌(PHC)患者的效果及对血清血管内皮生长因子(VEGF)和缺氧诱导因子-1α (HIF-1α)水平的影响。方法:选取佳木斯市肿瘤结核医院2017年2月—2019年2月收治的84例晚期PHC患者作为研究对象,采用随机数表法分为观察组和对照组,每组各42例。对照组给予载药微球经动脉化疗栓塞术(DEB-TACE)治疗,观察组在对照组基础上加用甲磺酸阿帕替尼治疗,比较两组患者近期疗效、不良反应发生率、血清VEGF、HIF-1α水平及生存情况。结果:观察组客观缓解率(ORR)为45.24%、疾病控制率(DCR)为76.19%,分别高于对照组的23.81%、52.38%,差异有统计学意义(χ^(2)=4.215、5.124,P<0.05)。两组患者发热、腹痛、恶心呕吐、骨髓抑制发生率比较,差异无统计学意义(χ^(2)=0.189、0.444、0.468、0.339,P>0.05)。观察组乏力、高血压、蛋白尿、手足综合征、皮疹发生率分别为45.24%、28.57%、38.10%、26.19%、11.90%,均高于对照组的23.81%、2.38%、0、0、0,差异有统计学意义(χ^(2)=4.215、8.992、19.765、12.658、5.317,P<0.05)。治疗前,两组患者血清VEGF、HIF-1α水平比较,差异无统计学意义(t=0.301、0.165,P>0.05)。治疗后,两组患者血清VEGF、HIF-1α水平均低于治疗前,且观察组血清VEGF水平为(108.73±9.84)pg/mL、HIF-1α水平为(298.63±28.67)pg/mL,均低于对照组的(139.52±12.94)pg/mL、(331.42±33.05)pg/mL,差异有统计学意义(t=12.275、4.857,P<0.05)。观察组中位生存期为(11.84±1.05)个月,对照组为(7.69±0.74)个月,观察组长于对照组,差异有统计学意义(t=20.937,P<0.05)。结论:甲磺酸阿帕替尼治疗晚期PHC患者能够提升患者的治疗效果,降低其血清VEGF、HIF-1α水平,延长其生存期,但相关不良反应有所增加,需加强监测。Objective:To investigate the effect of apatinib mesylate in treating patients with advanced primary hepatic cancer(PHC)and the effect on serum vascular endothelial growth factor(VEGF)and hypoxia-inducible factor-1α(HIF-1α)levels.Methods:84 patients with advanced PHC admitted to the hospital from February 2017 to February 2019 were selected for the study,and were divided into observation and control groups using the random number table method,with 42 cases in each group.The control group was treated with drug-laden microsphere transarterial chemoembolization(DEB-TACE),and the observation group was treated with apatinib mesylate.The recent efficacy,incidence of adverse effects,serum VEGF,HIF-1αlevels and survival were compared between the two groups.Results:The ORR of 45.24%and DCR of 76.19%in the observation group were higher than 23.81%and 52.38%of in the control group,with statistically significant differences(χ^(2)=4.215,5.124,P<0.05).There was no statistically significant difference in the incidence of fever,abdominal pain,nausea and vomiting,and bone marrow suppression between the two groups(χ^(2)=0.189,0.444,0.468,0.339,P>0.05).The incidence of malaise,hypertension,proteinuria,hand-foot syndrome,and rash in the observation group were 45.24%,28.57%,38.10%,26.19%,and 11.90%,which was higher than 23.81%,2.38%,0,0,and 0 in the control group,and the difference was statistically significant(χ^(2)=4.215,8.992,19.765,12.658,5.317,P<0.05).Before treatment,there was no statistically significant difference in serum VEGF and HIF-1αlevels between the two groups(t=0.301,0.165,P>0.05).After treatment,the serum VEGF and HIF-1αlevels in both groups were lower than those before treatment,and the serum VEGF level in the observation group was(108.73±9.84)pg/mL and HIF-1αlevel was(298.63±28.67)pg/mL,which were lower than(139.52±12.94)pg/mL,(331.42±33.05)pg/mL in the control group,and the differences were statistically significant(t=12.275,4.857,P<0.05).The median survival was(11.84±1.05)months in the observation gr

关 键 词：甲磺酸阿帕替尼 原发性肝癌 载药微球经动脉化疗栓塞 血管内皮生长因子 生存期 

分 类 号：R735.7[医药卫生—肿瘤]