摘要
目的探讨肝动脉化疗栓塞(TACE)联合恩替卡韦治疗乙肝病毒脱氧核糖核酸(HBV-DNA)阴性的乙型肝炎病毒(HBV)相关性肝癌病例的疗效和预后。方法选择HBV-DNA阴性的HBV相关性肝癌病人112例,按随机数字表法分为观察组和对照组,每组56例。观察组采用TACE联合恩替卡韦治疗,对照组仅行TACE治疗。检测并比较两组病人术前1周、术后1周及2周的肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)、γ-谷氨酰转肽酶(GGT)]、血清HBV-DNA,随访并比较治疗的有效率和生存情况。结果两组TACE术后1周均出现肝功能损害(ALT、AST、TBil和GGT升高),观察组ALT、AST和TBil均低于对照组(P<0.05)。术后2周两组ALT、AST、TBil和GGT均有下降,且观察组ALT、AST、TBil和GGT均低于对照组(P<0.05)。术后3个月观察组治疗有效率为35.72%,高于对照组的16.04%(P<0.05)。术后6个月生存率差异无统计学意义(P>0.05)。观察组和对照组术后12个月生存率分别为82.14%和58.93%(P<0.05),观察组HBV激活率为5.36%,低于对照组的14.29%(P<0.05)。结论对HBV-DNA阴性的HBV相关性肝癌病例采用TACE术联合恩替卡韦治疗,能改善TACE导致的肝功能损害,降低HBV的激活率,延长1年生存期。
Objective To evaluate efficacy and prognosis of treatment of transcatheter arterial chemoembolization （TACE） combined with Entecavir to prognosis of HBV-related hepatocellular carcinoma patients with undetectable HBV-DNA. Methods A total of 112 HBV-related hepatocellular carcinoma patients with undetectable HBV-DNA were chosen and randomly divided into observation （56 ca-ses） group and controls （56 cases） . The liver function （ ALT, AST,TBil,GGT） and HBV-DNA 1 week before TACE,1 and 2 weeks af-ter TACE were tested and compared. The effective rate and survival rate of patients were followed up. Results Liver function impair-ment occurred in 2 groups 1 week after TACE. The level of ALT,AST and TBil in observation group were lower than those of controls （P 〈 0. 05 ） . The level of ALT, AST, TBil and GGT all declined 2 weeks after TACE, and ALT, AST, TBil and GGT in observation group were all lower than those of controls （P 〈0. 05）. The effective rate of observation group （35. 72% ） was higher than that of controls （16. 04% ） 3 months after TACE （ P 〈 0. 05 ） . There was no significant difference in survival rate between 6 months after operation. The survival rate of observation group （82. 14% ） was higher than that of controls （58.93% ） 12 months after TACE （P 〈 0 .0 5 ） ,and the reactivation rate of HBV-DNA of observation group （5. 36% ） was lower than that of controls （ 14. 29% ） （P 〈 0. 05 ） . Conclusion Using the combination of TACE with Entecavir to treat HBV-related hepatocellular carcinoma patients with negative HBV-DNA can im-prove the liver function impairment caused by TACE,reduce the reactivation rate of HBV and prolonged the survival of 1 year.
出处
《安徽医药》
CAS
2017年第2期330-334,共5页
Anhui Medical and Pharmaceutical Journal
关键词
肝动脉化疗栓塞
恩替卡韦
乙型肝炎病毒相关性肝癌
预后
Transcatheter arterial chemoembolization
Entecavir
HBV-related hepatocellular carcinoma
Prognosis
