拉米夫定联合TACE治疗合并肝硬化的中晚期原发性肝癌

Lamivudine combined with transcatheter arterial chemoembolization on treatment of advanced hepatocellular carcinoma with cirrhosis

目的探讨拉米夫定联合经肝动脉栓塞化疗术(TACE)治疗HBV DNA阳性的合并肝硬化的中晚期原发性肝细胞癌(HCC)患者的临床效果。方法将50例HBV DNA阳性的合并肝硬化的中晚期HCC患者随机分为2组,治疗组25例予TACE+拉米夫定治疗组,对照组25例单纯予TACE治疗,观察比较2组患者肝功能Child-pugh积分、HBV DNA定量的变化及2a生存率。结果治疗1a及2a后,治疗组肝功能Child-pugh积分明显小于对照组(P均<0.05),HBV DNA转阴率和2a生存率均显著高于对照组(P<0.01或0.05)。结论 TACE联合拉米夫定治疗HBV DNA阳性的中晚期合并肝硬化的HCC患者,可抑制乙肝病毒复制,改善患者肝功能,提高生存率。

Objective It is to approach the therapeutic effects and prognosis of lamivudine combined with transcatheter arterial chemoembolization（TACE） on advanced hepatocellular carcinoma（HCC） with HBV DNA positive cirrhosis.Methods 50 HBV DNA positive cirrhosis patients with advanced HCC were divided into 2 groups with 25 cases in each group.The patients were treated with TACE and lamivudine in treatment group,and with TACE alone in control group.The changes of Child-pugh scores and HBV DNA quantification were ovserved in both groups,and the 2-year survival rates of both groups were recorded and compared.Results In 1 year and 2 years later,the liver function Child-pugh scores in treatment group were significantly lower than that in control group;and the HBV DNA negative rate and 2-years survival rate were significantly higher than that in control group（P0.01 or 0.05）.Conclusion TACE combined with lamivudine in HBV DNA positive cirrhosis patients with advanced HCC can inhibit the HBV replication,improve the liver function,and increase the survival rate.