华蟾素片联合125I粒子植入术治疗晚期原发性肝癌疗效及对相关血液生化指标的影响

目的:探讨华蟾素片联合放射性125I 粒子植入术对晚期原发性肝癌患者术后外周血T淋巴细胞亚群及血清甲胎蛋白（AFP）、癌胚抗原（CEA）水平变化的影响。方法:选取2012年4月至2017年2月我院84例晚期原发性肝癌患者，随机数字表法分为对照组（n=42）与研究组（n=42），另选取同期于我院进行健康体检者42例设为健康组。对照组采用放射性125I 粒子植入术，研究组采用放射性125I 粒子植入术+华蟾素片，持续治疗4周。治疗结束后统计对比两组临床疗效、不良反应发生率、并发症发生率，入院时及疗程结束后对比三组外周血T淋巴细胞亚群（CD3+、CD4+、CD8+、CD4+/CD8+）、血清AFP、CEA水平、生存周期。结果:两组临床疗效比较，研究组与对照组间无明显差异（P＞0.05）。治疗前后三组血清CD3+、CD4+、CD8+、CD4+/CD8+水平比较存在明显差异（P＜0.05），且研究组CD3+、CD4+、CD4+/CD8+水平较对照组高，CD8+水平较对照组低（P＜0.05）。治疗前后三组血清AFP及CEA水平相比存在明显差异（P＜0.05），治疗后研究组血清AFP及CEA水平较对照组低（P＜0.05）。研究组骨髓抑制、白细胞减少、胃肠道反应、脱发发生率较对照组低，但无明显差异（P＞0.05）。两组并发症发生率比较，研究组与对照组［9.52%（4/42） vs 14.29%（6/42）］无明显差异（P＞0.05）。研究组平均生存期及中位生存期较对照组长（P＜0.05）。结论:联合采用华蟾素片及放射性125I 粒子植入术治疗晚期原发性肝癌效果显著，可增强患者机体免疫功能，降低血清CEA、AFP水平，且不良反应及并发症较少，具有安全性。

Combination of cinobufotalin tablets and radioactive 125I particle implantation on peripheral blood T lymphocyte subsets after operation and serum CEA and AFP levels change in patients with advanced primary liver cancer

Objective:To investigate the combination of cinobufotalin tablets and radioactive 125I particle implantation on peripheral blood T lymphocyte subsets after operation and serum alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA)levels change in patients with advanced primary liver cancer.Methods:A total of 84 patients with advanced primary liver cancer from April 2012 to February 2017 in our hospital were selected and randomly divided into the control group(n=42)and the study group(n=42).Another 42 cases were selected as the healthy group in our hospital during the same period.The control group was treated with radioactive 125I particle implantation,and the study group was treated with radioactive 125I particle implantation combined with cinobufotalin tablets,and both groups were treated for 4 weeks.The clinical efficacy,incidence of side effects and complication rate were compared between the two groups after treatment.The T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+),serum AFP and CEA levels in peripheral blood of the three groups were compared at the time of admission and after the course of treatment.Results:There was insignificant difference in the clinical efficacy between the study group and the control group(P＞0.05).There were significant differences in serum CD3+,CD4+,CD8+ and CD4+/CD8+ levels in the three groups before and after treatment(P＜0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in the study group were higher than that in the control group,and the level of CD8+ was lower than that of the control group(P＜0.05).There were significant differences in serum AFP and CEA levels in the three groups(P＜0.05).After treatment,the serum AFP and CEA levels in the study group were lower than those in the control group(P＜0.05).The incidence rate of bone marrow suppression,WBC reduction,gastrointestinal reaction and alopecia in the study group was lower than that in the control group.But there was insignificant difference(P＞0.05).There was insignificant difference in the complication rates between the study group and the control group［9.52%(4/42) vs 14.29%(6/42)］(P＞0.05).Conclusion:The combination of cinobufotalin and radioactive 125 particle implantation in the treatment of advanced primary liver cancer is significant and it can enhance the immune function of the patients.It can reduce the serum CEA and AFP levels,and there were less toxic side effects and complications.It has high safety.