替比夫定联合TACE治疗合并肝硬化的中晚期原发性肝癌的临床研究

Clinical study on telbivudine combined with transcatheter arterial chemoembolization in treatment of advanced hepatocellular carcinoma with liver cirrhosis

目的探讨替比夫定联合经皮肝动脉栓塞化疗术(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)患者的疗效。方法将55例HBV DNA阳性的合并肝硬化的中晚期HCC患者随机分为TACE+替比夫定治疗组(28例),单纯TACE对照组(27例),观察比较2组患者肝功能Child-pugh积分、HBV DNA定量及2 a生存率。结果治疗1 a及2 a后,肝功能Child-pugh积分治疗组明显小于对照组(均P<0.05);治疗组HBV DNA转阴率均显著高于对照组(均P<0.01);治疗组和对照组2 a生存率分别为61%和33%(P<0.05)。结论 TACE联合替比夫定治疗HBV DNA阳性的合并肝硬化的中晚期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 of telbivudine combined with transcatheter arterial chemoembolization （TACE） in treatment of advanced hepatocellular carcinoma （HCC） patients with HBV DNA positive cirrhosis. Methods 55 advanced HCC patients with HBV DNA positive cirrhosis were divided into treatment group （28 cases） for TACE plus telbivudine and control group （27 cases） for TACE alone. The liver function Child-pugh points of patients, HBV DNA quantification and 2-year survival rate were observed and compared between both gruops. Results One year and two years later, the liver function Child-pugh points in treatment group were significantly lower than that in control group （ all P 〈 0.05） , the HBV DNA negative rate of treatment group were significantly higher than that of control group （ all P 〈 0.01 ） , 2 - year survival rates were 61% in treatment group and 33% in control group （P 〈 0.05）. Conclusion TACE combined with telbivudine in HBV DNA positive patients with advanced liver cirrhosis and HCC, can inhibit HBV replication, improve liver function, and increase the survival rate.