恩替卡韦与胸腺五肽联合治疗HBV相关肝细胞癌对患者肝功能和预后的影响

Effect of entecavir combined with thymopentin on hepatic function and prognosis in patients with HBV-related hepatocellular carcinoma

目的探讨恩替卡韦与胸腺五肽联合治疗乙型肝炎病毒(HBV)相关肝细胞癌对患者肝功能和预后的影响。方法选取2016年1月至2018年3月海南省琼海市人民医院治疗的HBV相关肝细胞癌患者87例,根据患者意愿分为观察组(n=43)和对照组(n=44),两组在常规放化疗基础上,观察组给予恩替卡韦与胸腺五肽联合治疗,对照组给予恩替卡韦治疗,采用全自动生化分析仪检测治疗前后肝功,化学发光免疫分析仪检测甲胎蛋白(AFP),采用荧光定量PCR法检测HBV DNA含量,同时随访患者预后。结果观察组和对照组治疗后肝功较治疗前改善(P<0.05);观察组治疗后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)和总胆汁酸(TBA)分别为(420.21±115.58)IU/L、(210.16±98.68)IU/L、(21.51±8.46)μmol/L和(42.20±13.87)mg/L,明显低于对照组(510.05±103.65)IU/L、(303.44±101.00)IU/L、(30.31±7.20)μmol/L、(60.05±14.55)mg/L,差异有统计学意义(P<0.05)。观察组和对照组治疗后HBV DNA和AFP水平较治疗前降低(P<0.05);观察组治疗后HBV DNA和AFP分别为(2.55±0.91)lg copies/mL和(4.10±0.98)μg/L,明显低于对照组(3.18±0.94)lg copies/mL、(5.28±1.00)μg/L,差异有统计学意义(P<0.05)。观察组中位总体生存时间为8个月(95%CI:7.36~8.64),明显高于对照组6个月(95%CI:5.46~6.54),差异有统计学意义(P<0.05)。结论恩替卡韦与胸腺五肽联合治疗HBV相关肝细胞癌有较好的效果,能改善患者肝功能及预后。

Objective To investigate the effect of entecavir combined with thymopentin on liver function and prognosis of patients with hepatitis B virus(HBV)associated hepatocellular carcinoma(HCC).Methods From January 2016 to March2018,87 patients in Hainan Qionghai People’s Hospital with HBV-related hepatocellular carcinoma were divided into observation group(n=43)and control group(n=44)according to their wishes.The observation group was treated with entecavir combined with thymopentin,and the control group was treated with entecavir.The liver function was detected by automatic biochemical analyzer;alpha-fetoprotein(AFP)was detected by chemiluminescence immunoassay;HBV DNA was detected by fluorescence quantitative PCR.The prognosis of patients was followed up.Results Alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil)and total bile acid(TBA)in the observation group were(420.21±115.58)IU/L,(210.16±98.68)IU/L,(21.51±8.46)μmol/L and(42.20±13.87)mg/L,respectively,which were significantly lower than those in the control group(510.05±103.65)IU/L,(303.44±101.00)IU/L,(30.31±7.20)mol/L,(60.05±14.55)mg/L(P<0.05).HBV DNA and alpha-fetoprotein(AFP)in the observation group were(2.55±0.91)lg copies/mL and(4.10±0,98)μg/L,respectively,which were significantly lower than those in the control group(3.18±0.94)lg copies/mL,(5.28±1.00)g/L(P<0.05).The median overall survival time of the observation group was 8 months(95%CI:7.36-8.64),which was significantly higher than that of the control group(95%CI:5.46-6.54)(P<0.05).Conclusion Entecavir combined with thymopentin in the treatment of HBV-related hepatocellular carcinoma had a better effect,and could improve the liver function and prognosis of patients.