血必净对肝癌经导管肝动脉栓塞化疗术后血浆内毒素、VEGF影响的临床研究

Study on Xuebijing injection on plasma endotoxin and VEGF of the liver cancer treated with transcatheter arterial chemoembolization

目的探讨血必净注射液对肝癌患者经导管肝动脉栓塞化疗术(TACE)后血浆内毒素、VEGF及肝功能的影响。方法将65例肝癌患者随机分为血必净组与对照组;TACE后,两组均行常规保肝(还原性谷胱甘肽、甘草酸二胺等)治疗,疗程7 d;治疗组在此基础上加用血必净注射液疗程7 d。检测两组TACE前及TACE后第3天、7天血浆内毒素、VEGF及肝功能水平,观察发热、恶心呕吐及腹痛等副作用。结果介入术后第3天,两组血浆内素毒含量均较术前明显升高(P<0.05),血必净组内毒素含量明显低于对照组(P<0.05);介入术后第7天,两组血浆内毒素含量均降低,但血必净组降至术前水平,对照组内毒素水平明显高于血必净组及术前(P<0.05)。介入术后第3天,两组血浆VEGF含量较术前有所升高(P>0.05)。介入术后第7天,两组血浆VEGF均较术前及术后第3天明显升高,但血必净组明显低于对照组(P<0.05)。介入术后,血必净组发热、恶心呕吐、疼痛发生率均明显低于对照组(P<0.05);介入术后第3天,血必净组ALT、AST、TBIL水平均明显低于对照组(P<0.05)。结论血必净能降低晚期肝癌患者TACE术后血浆内毒素水平,从而减轻对肝功能的损伤,缓解术后栓塞综合征;同时血必净也一定程度上降低了血浆VEGF水平,影响其预后,近期疗效确切,值得临床推广。

【Objective】 To discuss the influence of Xuebijing injection to plasma endotoxin, VEGF and liver function in the liver cancer treated with transcatheter arterial chemoembolization（TACE）. 【Methods】 Six- ty-five liver cancer patients were randomly divided into two groups. The treatment group was given Xuebijing injection 100 mL static drops accompanied by conventional treatment to protect liver blood after treated, two times one day, 7 days one treatment. The control group was only given the conventional treatment. At the same time, the endotoxin, VEGF and liver function level were detected before TACE, on the 3rd day, 7th day after TACE. 【Results】 The plasma endotoxin level of the two groups were higher compared the level before TACE（P 0.05）, but which of the Xuebijing group significantly lower than the control group, on the 3rd day after TACE. Both of the plasma endotoxin level of the two groups was decreased, but the Xuebijing group to the level before TACE, which of the control group was significantly higher than the Xuebijing group and the level before TACE, on the 7th day after TACE. The level of plasma VEGF of the two groups were higher than that before TACE on the 3rd day, but there were no significantly difference（P 0.05）. On the 7th day after TACE, both of the level of plasma VEGF of the two groups were significantly higher than that before TACE and on the 3rd day, but which of the Xuebijing group significantly lower than the control group（P 0.05）. The incidence of fever, vomit and bellyache of the Xuebijing group were decreased significantly than the control group after TACE（P 0.05）. The serum ALT, AST, Tbil of the Xuebijing group were significantly lower than the level of the control group on the 3rd day after TACE（P 0.05）. 【Conclusion】 Xuebijing in- jection can reduce the plasma endotoxin and VEGF level in the liver cancer treated with TACE, thus reduc- ing liver damage and affecting the prognosis.