拉米夫定联合胸腺肽在肝癌合并乙型肝炎术后治疗中的应用

目的研究拉米夫定联合胸腺肽治疗肝癌合并乙型肝炎术后患者的临床疗效。方法选取本院收治的30例肝癌合并乙型肝炎患者作为临床研究资料,按照治疗方法将所有患者分为2组,单纯接受手术切除治疗的患者12例作为对照组,术后应用拉米夫定联合胸腺肽治疗的患者18例作为研究组,对比2组患者肝功能,乙肝病毒复制相关指标,肝癌术后复发率和生存率。结果术前及术后早期2组患者Child-pugh评分无显著性差异。1年后对照组Child-pugh评分逐渐升高,3年后对照组Child-pugh评分升至(10.5±1.9),明显高于治疗组。治疗组血清HBV DNA转阴率以及HbeAg转阴率均显著高于对照组。治疗组1、2、3年生存率高于对照组。治疗组1、2、3年复发率低于对照组。结论拉米夫定联合胸腺肽治疗肝癌合并乙型肝炎术后患者疗效确切,可以有效改善患者肝功能,促进血清HBV DNA以及HbeAg转阴,且可以显著提高患者3年生存率。可以作为肝癌合并乙型肝炎术后患者的推荐治疗方案。

Application of lamivudine in combination with thymosin in the postoperative treatment of hepatocellular carcinoma associated with hepatitis B

Objective To study the clinical efficacy of lamivudine in combination with thymosin in the postoperative treatment of patients with hepatocellular carcinoma associated with hepatitis B.Methods Thirty patients from our hospital with hepatocellular carcinoma and hepatitis B were selected as research subjects.According to the treatment methods,the patients were divided into two groups.The control group(n=12) received simple surgical resection,while the treatment group(n=18) received the combined therapy of lamivudine-thymosin.Liver function,hepatitis B virus replication-related indicators,post-operative recurrence rate and survival rate were compared between the two groups.Results Preoperative and early postoperative Child-pugh scores showed no significant differences between the two groups.After one year,the Child-pugh score in the control group began to rise,and reached(10.5±1.9) at the third year,which was significantly higher than that in the treatment group.Serum HBV DNA negative conversion rate and HbeAg negative rate were significantly higher in the treatment group than in the control group.The survival rates at the first,second,and third year were higher in the treatment group than in the control group.The recurrence rates at the first,second and third year were lower in the treatment group than in the control group.Conclusions Combined lamivudine-thymosin regimen has been proved to have certain efficacy for treatment of hepatocellular carcinoma associated with hepatitis B.It can promote the positive-negative conversion of serum HBV DNA and HbeAg,and significantly increase 3-year survival rate.Thus it can be used as recommended treatment regimen after surgery in patients with hepatocellular carcinoma associated with hepatitis B.