华蟾素联合化学药物经动脉灌注栓塞治疗原发性肝癌的价值探讨

目的探讨华蟾素联合化学药物经动脉灌注栓塞(TACE)治疗原发性肝癌的临床价值。方法144例HbsAg阳性肝癌患者,A组76例采用动脉灌注(TAI)华蟾素100 m l、顺铂、5-氟脲嘧啶及阿霉素碘化油乳剂栓塞(TAE);B组68例采用顺铂、5-氟脲嘧啶及阿霉素碘化油乳剂动脉灌注栓塞(TACE)。结果A组有效率(PR+MR)86.84%,淋巴细胞转化率(LTT)、T细胞亚群CD3+、CD4+细胞百分比及CD4+/CD8+比值上升,血清HBV DNA 21例下降、46例不变、9例上升,而外周血白细胞计数无显著变化;1、2年生存率分别为86.84%(66/76)和71.05%(54/76);B组有效率(PR+MR)72.73%,LTT、T细胞亚群CD3+、CD4+细胞百分比及CD4+/CD8+比值下降,血清HBV DNA 2例下降、20例不变、46例上升,外周血白细胞计数下降;1、2年生存率分别72.73%(48/68)和54.41%(37/68)。2组近期有效率、T细胞亚群变化、HBV DNA变化及生存率的差异均有显著意义。结论应用华蟾素联合化学药物经动脉灌注栓塞治疗原发性肝癌,对改善患者生存质量及提高生存期有重要价值。

Clinical Study of Using Cinobufotalin and Chemotherapeutic Agents by Transcatheter Arterial with Oily Chemoembolization in the Treatment of Primary Liver Cancer

Objective To evaluate the effect of cinobufotalin and chemotherapeutic agents by transcatheter arterial with oilychemoembolization(TACE) in the treatment of primary liver cancer.Methods 144 patients with HCC proved histopathologically were divided into 2 groups.76 of them(group A) were treated by transcatheter arterial infusion(TAI) with cinobufotalin 100 ml,DDP and 5-FU,then embolism with iodized oil mixed ADM;while the other 68 patients(group B) were treated by TAI with DDP and 5-FU,then embolism with iodized oil mixed ADM.The serum T lymphocytes,HBV DNA,AFP and CT scan were acquired before and after treatment.Results The effective rate(PR+MR) of group A was 86.64%,the lymphocyte transformation rate(LTT),T lymphocytes CD_3~+,CD_4~+proportion and CD_4~+/CD_8~+ratio markedly increased;HBV DNA descended in 21 cases,unchanged in 46 cases,and elevated in 9 cases;1 and 2 year survival rate was 86.84%(66/76)and71.05%(54/76) respectively.The effective rate(PR+MR) of group B was 72.73%,LTT,T lymphocytesCD_3~+,CD_4~+proportion and CD_4~+/CD_8~+ratio markedly descended;HBV DNA descended in 2 cases,unchanged in 20 cases and elevated in 46 cases;1 and 2 year survival rate was 72.73%(48/68) and 54.41%(37/68) respectively.There were significant statistical differences between the two groups(P<0.05) regarding the effective rate.T lymphocytes,HBV DNA and surivival rates.Conclusion Using cmobufortalin with chemotherapentic agents by TAI to treat HCC is of important value in improving the survival qnality and period.