还原型谷胱甘肽联合吲哚美辛栓在晚期原发性肝癌TACE治疗中的应用  

Application effect of reduced glutathione combined with indomethacin suppositories in transcatheter chemoembolization for patients with advanced primary liver cancer

作　　者：单志斌 林丽香 严子建 周立群 曾海波 梁明超 SHAN Zhi-bin;LIN Li-xiang;YAN Zi-jian;ZHOU Li-qun;ZENG Hai-bo;LIANG Ming-chao(Interventional Department,the Affiliated Shunde Hospital of Jinan University(the Second People's Hospital of Shunde,Feng Yaojing Memorial Hospital of Shunde),Foshan 528305,Guangdong,CHINA)

机构地区：[1]暨南大学附属顺德医院(佛山市顺德区第二人民医院、佛山市顺德区冯尧敬纪念医院)介入科,广东佛山528305

出　　处：《海南医学》2024年第20期2901-2905,共5页Hainan Medical Journal

摘　　要：目的探讨还原型谷胱甘肽联合吲哚美辛栓在晚期原发性肝癌(PLC)经动脉导管化疗栓塞术(TACE)治疗中的应用效果。方法选择2020年1月至2023年9月暨南大学附属顺德医院收治且行TACE治疗的50例晚期PLC患者作为研究对象,按随机数表法分为对照组和观察组各25例。两组患者均采用TACE介入治疗,对照组患者术后采取还原型谷胱甘肽静滴治疗,观察组在对照组的基础上联合吲哚美辛栓治疗,两组患者均治疗4周。治疗4周后,比较两组患者的治疗效果,以及治疗前后的肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)和总胆红素(TBIL)]、临床症状评分、免疫指标和生活质量[健康状况调查问卷(SF-36)],比较两组患者治疗期间的不良反应发生率及6个月内的生存率。结果观察组患者治疗后的总有效率为68.00%,明显高于对照组的40.00%,差异有统计学意义(P<0.05);观察组患者治疗后的ALT、AST、ALP、TBIL水平分别为(40.14±11.58)U/L、(40.02±7.57)U/L、(67.20±12.55)U/L、(10.36±2.10)μmol/L,明显低于对照组的(47.31±10.62)U/L、(45.15±9.63)U/L、(72.09±14.10)U/L、(13.01±2.34)μmol/L,差异均有统计学意义(P<0.05);观察组患者治疗后的恶心呕吐、肝区疼痛、腹泻、发热的症状评分分别为(0.55±0.18)分、(0.62±0.17)分、(0.50±0.15)分、(0.55±0.12)分,明显低于对照组的(1.01±0.32)分、(0.90±0.25)分、(0.73±0.23)分、(0.91±0.20)分,差异均有统计学意义(P<0.05);观察组患者治疗后的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平分别为(68.14±4.06)%、(34.61±2.23)%、(43.64±4.13)%、1.94±0.25,明显高于对照组的(60.13±3.37)%、(30.32±2.38)%、(37.41±3.92)%、1.41±0.18,差异均有统计学意义(P<0.05);观察组患者治疗后的生活质量各项评分明显高于对照组,差异均有统计学意义(P<0.05);治疗期间,观察组患者的不良反应总发生率为16.00%,略低于对照组的24.00%,但差异无统Objective To investigate the application effect of reduced glutathione combined with indomethacin suppositories in the treatment of transcatheter chemoembolization(TACE)for patients with advanced primary liver cancer(PLC).Methods Fifty patients with advanced PLC treated with TACE from January 2020 to September 2023 in the Affiliated Shunde Hospital of Jinan University were selected and divided into a control group and an observation group by random number table method,with 25 patients in each group.Based on TACE interventional therapy,patients in the control group were treated with intravenous infusion of reduced glutathione after surgery,and those in the observation group were treated with indomethacin suppositories on the basis of the control group,all for 4 weeks.After 4 weeks of treatment,the treatment outcomes of two groups were compared,as well as the liver function indicators(alanine aminotransferase,ALT;aspartate aminotransferase,AST;alkaline phosphatase,ALP;and total bilirubin,TBIL),clinical symptom scores,immune indicators,and quality of life(36-item Short-Form,SF-36)before and after treatment.The incidence of adverse reactions and survival rate within 6 months between the two groups of patients during treatment were compared.Results The total effective rate of the observation group was 68.00%,which was significantly higher than 40.00%of the control group(P<0.05).After treatment,the levels of ALT,AST,ALP,and TBIL in the observation group were(40.14±11.58)U/L,(40.02±7.57)U/L,(67.20±12.55)U/L,and(10.36±2.10)μmol/L,respectively,which were significantly lower than(47.31±10.62)U/L,(45.15±9.63)U/L,(72.09±14.10)U/L,(13.01±2.34)μmol/L in the control group(P<0.05).The symptom scores of nausea and vomiting,liver pain,diarrhea,and fever in the observation group after treatment were(0.55±0.18)points,(0.62±0.17)points,(0.50±0.15)points,(0.55±0.12)points,which were significantly lower than(1.01±0.32)points,(0.90±0.25)points,(0.73±0.23)points,(0.91±0.20)points in the control group(P<0.05).The CD3^(+)

关 键 词：原发性肝癌 经动脉导管化疗栓塞术 还原型谷胱甘肽 吲哚美辛栓 肝功能 疗效 

分 类 号：R735.7[医药卫生—肿瘤]