抗病毒对肝动脉化疗栓塞治疗乙肝后中晚期肝癌的作用

Antiviral effects of transcatheter hepatic arterial chemoembolization on middle and advanced stage hepatitis B virus-related liver cancer

目的观察抗病毒对肝动脉化疗栓塞(TACE)治疗乙肝后中晚期肝癌的作用。方法 60例HBVDNA阳性的中晚期肝癌患者随机分为治疗组(36例)和对照组(24例),对照组给予常规TACE治疗,治疗组在对照组基础上,口服拉米夫定抗HBV,比较两组治疗1月和3月后的肝功能、Child-Pugh评分、HBVDNA水平,治疗3月后实体瘤缩小疗效、生活质量改善情况及生存期。结果治疗后1月、3月治疗组ALT、TBil、HBVDNA水平均较对照组降低(P<0.05,P<0.01);治疗后3月AST、AFP较对照组降低(P<0.05,P<0.01),ALB较对照组升高(P<0.05),Child-Pugh分级较对照组有改善(P<0.05)。治疗后3月两组实体瘤缩小疗效差异无统计学意义(P>0.05),在提高生活质量、延长生存期方面,治疗组明显优于对照组(P<0.05)。结论抗病毒对TACE治疗的乙肝后中晚期肝癌患者具有重要的作用。

Objective To evaluate the antiviral effects of transcatheter hepatic arterial chemoembolization（TACE） on middle and advanced stage hepatitis B virus-related liver cancer.Methods 60 HBVDNA positive patients with middle and advanced stage liver cancer were randomly divided into treatment group（n=36） and control group（n=24）.The control group received conventional TACE treatment and the treatment group was given lamivudine combined with TACE.Liver function,Child-pugh score,HBV DNA levels after 1 and 3 months of therapy,and solid tumor reduction efficacy,quality of life after 3 months of therapy and lifetime of the two groups were analyzed.Results ALT,TBil and HBV DNA levels of the treatment group were lower than the control group after 1 and 3 months of therapy（P0.05,P0.01）.AST and AFP was lower,ALB was higher and Child-pugh grade was better in the treatment group than the control group after 3 months of therapy（P0.05,P0.01）.There was no significant difference in solid tumor reduction between the two groups but the life time was improved in the treatment group compared to the control group（P0.05）.Conclusion Anti-viral therapy plays an important role on post-TACE treatment of middle and advanced stage hepatitis B virus-related liver cancer.