Clinical study of antiviral treatment combined with transcatheter arterial chemoemholization (TACE) in patients with hepatitis B cirrhosis complicated hepatocellular carcinoma
-
摘要: 目的探讨抗病毒联合经导管肝动脉化疗栓塞(TACE)治疗在乙型肝炎后肝硬化合并肝细胞癌(HCC)患者中的临床疗效。方法回顾性分析抗病毒联合TACE治疗78例乙型肝炎后肝硬化合并HCC患者的临床疗效,并与同期单独行TACE患者81例对比,观察比较两组患者1、2年生存率、肝功能Child-Pugh积分及HBV DNA定量的变化。两组基线临床资料(如性别、年龄、肿瘤的大小、实验室检查及Child-Pugh评分)比较差异无统计学意义(P均>0.05)。结果治疗1、2年后,治疗组HBV DNA阴转率均显著高于对照组(P均<0.0001),肝功能Child-Pugh积分治疗组明显低于对照组(P均<0.001),差异均有统计学意义。治疗组和对照组1、2年生存率分别为83.33%、66.67%和59.2%、36.67%(P均<0.001),差异均有统计学意义。结论应用核苷酸类似物联合TACE治疗乙型肝炎后肝硬化合并HCC的患者,可抑制HBV复制,保护患者肝功能,提高患者生存率。Abstract: Objective To investigate the effects of antiviral treatment combined with transcatheter arterial chemoemholization (TACE) in patients with hepatitis B cirrhosis complicated hepatocellular carcinoma (HCC) .Methods Retrospectively analyzed the effects of antiviral treatment combined with TACE in 78 cases with Hepatitis B cirrhosis complicated HCC, and compared with 81 patients that separately used TACE at the same time.One or two years′ survival rate, Child-Pugh score and HBV DNA were measured.There were no significant differences between two groups in basic clinical materials (P>0.05) (include sex, age, tumor size, laboratory examination and Child-Pugh score) .Results After one or two years′ treatment, the conversion rates of HBV DNA of treatment group were significantly higher than those of the control group (P<0.0001) , Child-Pugh scores of treatment group were significantly lower than those of the control group (P<0.001) , the differences were significantly.The one or two years′ survival rates of treatment group were 83.33% and 66.67%, while control group were 59.2% and 36.67% (P<0.001) , the differences were significantly.Conclusion Nucleoside analogues combined with TACE, can reduce the level of HBV DNA, protect liver functions and increase survival rates considerably in patients with hepatitis B cirrhosis complicated HCC.
-
Key words:
- chemoembolization /
- therapeutic /
- carcinoma
-
[1]李震, 胡道予.肝癌介入治疗后肝脏状况的研究[J].国外医学.临床放射学分册, 2002, 25 (6) :357-360. [2]杨秉辉, 夏景林, 黄力文, 等.我国肝癌“临床相”30年的变迁—原发性肝癌3250例的对比研究[J].中华医学杂志, 2003, 83 (12) :1053-1057. [3] 中华人民共和国卫生部.原发性肝癌规范化诊疗规范 (2011版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1159. [4]中华医学会肝病学分会, 中华医学会感染病分会.慢性乙型肝炎防治指南 (2010版) [J].临床肝胆病杂志, 2011, 27 (1) :Ⅰ-. [5]Mahmood S, Niiyama G, Kamei A, et al.Influence of viralload and genotype in the progression of hepatitis B associat-ed liver cirrhosis to hepatocellular carcinoma[J].Liver Int, 2005, 25 (2) :220-225. [6]Wands JR.Prevention of hepatocellular carcinoma[J].NEngl J Med, 2004, 351 (10) :1567-1570. [7]Miao RY, Zhao HT, Yang HY, et al.Postoperative adjuvantantiviraltherapy for hepatitis B/C virus-related hepatocellularcarcinoma:Ameta-analysis[J].World J Gastroenterol, 2010, 16 (23) :2931-2942. [8]方程, 宣吉晴, 雷正明.手术切除联合阿德福韦酯应用对原发性肝癌复发和生存期的影响[J].当代医学, 2010, 16 (4) :73-74. [9]彭齐荣, 肖必, 程涛, 等.拉米夫定联合微波消融治疗原发性肝癌40例[J].现代肿瘤医学, 2010, 18 (4) :755-757.
本文二维码
计量
- 文章访问数: 224
- HTML全文浏览量: 17
- PDF下载量: 102
- 被引次数: 0