抗病毒对肝动脉化疗栓塞治疗乙肝后中晚期肝癌的作用

占国清; 谭华炳; 朱琳; 李儒贵; 张薇薇; 胡波; 杜卫星

抗病毒对肝动脉化疗栓塞治疗乙肝后中晚期肝癌的作用

郧阳医学院附属人民医院肝病治疗中心

详细信息

中图分类号: R735.7
计量
- 文章访问数: 3058
- HTML全文浏览量: 34
- PDF下载量: 815
- 被引次数: 0
出版历程
- 出版日期: 2010-04-20

Antiviral effects of transcatheter hepatic arterial chemoembolization on middle and advanced stage hepatitis B virus-related liver cancer

摘要

摘要: 目的观察抗病毒对肝动脉化疗栓塞（TACE）治疗乙肝后中晚期肝癌的作用。方法 60例HBVDNA阳性的中晚期肝癌患者随机分为治疗组（36例）和对照组（24例）,对照组给予常规TACE治疗,治疗组在对照组基础上,口服拉米夫定抗HBV,比较两组治疗1月和3月后的肝功能、Child-Pugh评分、HBVDNA水平,治疗3月后实体瘤缩小疗效、生活质量改善情况及生存期。结果治疗后1月、3月治疗组ALT、TBil、HBVDNA水平均较对照组降低（P<0.05,P<0.01）;治疗后3月AST、AFP较对照组降低（P<0.05,P<0.01）,ALB较对照组升高（P<0.05）,Child-Pugh分级较对照组有改善（P<0.05）。治疗后3月两组实体瘤缩小疗效差异无统计学意义（P>0.05）,在提高生活质量、延长生存期方面,治疗组明显优于对照组（P<0.05）。结论抗病毒对TACE治疗的乙肝后中晚期肝癌患者具有重要的作用。
- 拉米夫定 /
- 化学栓塞,治疗性 /
- 肝肿瘤 /
- 抗病毒药
Abstract: Objective To evaluate the antiviral effects of transcatheter hepatic arterial chemoembolization (TACE) on middle and advanced stage hepatitis B virus-related liver cancer.Methods 60 HBVDNA positive patients with middle and advanced stage liver cancer were randomly divided into treatment group (n=36) and control group (n=24) .The control group received conventional TACE treatment and the treatment group was given lamivudine combined with TACE.Liver function, Child-pugh score, HBV DNA levels after 1 and 3 months of therapy, and solid tumor reduction efficacy, quality of life after 3 months of therapy and lifetime of the two groups were analyzed.Results ALT, TBil and HBV DNA levels of the treatment group were lower than the control group after 1 and 3 months of therapy (P<0.05, P<0.01) .AST and AFP was lower, ALB was higher and Child-pugh grade was better in the treatment group than the control group after 3 months of therapy (P<0.05, P<0.01) .There was no significant difference in solid tumor reduction between the two groups but the life time was improved in the treatment group compared to the control group (P<0.05) .Conclusion Anti-viral therapy plays an important role on post-TACE treatment of middle and advanced stage hepatitis B virus-related liver cancer.
- lamivudine /
- chemoembolization /
- therapeutic /
- liver neoplasms

HTML全文

参考文献(11)

[1]韩秋玉, 韦志平.拉米夫定联合肝动脉化疗对乙肝后肝癌病人的临床治疗观察[J].现代医药卫生, 2009, 25 (7) ∶984-985.

[2]Yeo W, Chan PK, Zhong S, et al.Frequency of hepatitis B Virusreactivation in cancer patients undergoing cytotoxic chemotherapy:aprospective study of 626 patients with identification of riskfactors[J].J Med Virol, 2000, 62 (3) ∶299-307.

[3]中国抗癌协会肝癌专业委员会.原发性肝癌的临床诊断与分期标准[J].中华肝脏病杂志, 2001, 9 (6) ∶324.

[4]孙燕, 周际昌.临床肿瘤内科手册[M].第4版.北京:人民卫生出版社, 2004∶158.

[5]马亦龙, 纪昌学.经皮穿脾选择性门静脉栓塞术在中晚期肝癌综合治疗中的应用[J].中国介入影像与治疗学, 2005, 2 (5) ∶345-347.

[6]郑勤, 徐翰峰, 何耿劲, 等.肝动脉化疗栓塞术对肝癌患者乙肝病毒活动状态的影响[J].临床肿瘤学杂志, 2008, 13 (12) ∶1096-1098.

[7]Ohkubo K, Kato Y, Ichikawa T, et al.Viral load is a significantprognostic factor for hepatitis B irusassociated hepatocellular carcino-ma[J].Cancer, 2002, 94 (10) ∶2663-2668.

[8]Yeo W, Chan PK, Zhong S, et al.Frequency of hepatitis B virus re-activation in cancer patients undergoing cytotoxic chemotherapy:aprospective study of 626 patients with identification of riskfactors[J].J Med Virol, 2000, 62 (3) ∶299-307.

[9]Yeo W, Lam KC, Zee B, et al.Hepatitis B reactivation in patientswith hepatocellular carcinoma undergoing systemic chemotherapy[J].Ann Oncol, 2004, 15 (11) ∶1661-1666.

[10]王辉, 陈涛, 熊茂明, 等.乙肝病毒在肝癌围手术期的防治[J].肝胆外科杂志, 2001, 9 (1) ∶927.

[11]Bolukbas C, Bolukbas FF, Kendir T, et al.The effectiveness of lami-vudine treatment in cirrhotic patients with HBV precore mutations:aprospective, open-label study[J].Dig Dis Sci, 2006, 51 (7) ∶1196.

施引文献

资源附件(0)

访问统计