原发性肝癌患者围治疗期血清VEGF、BFGF及免疫学指标变化的价值研究

Study on the value of serum VEGF,BTGF and immunological indexes in patients with primary liver cancer during perioperative period

目的研究索拉菲尼联合肝动脉化疗栓塞术(TACE)治疗老年原发性肝癌对血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(BFGF)及免疫学指标影响,为临床诊治提供参考。方法选择该院于2011年10月至2016年10月收治的原发性肝癌手术患者86例作为研究对象,按照数字随机表法分为试验组和对照组,每组43例。其中对照组行单纯TACE治疗,试验组在对照组基础上联合索拉菲尼。对比两组患者术前、术后24h、术后72h的血清VEGF、BFGF及免疫功能指标变化。结果术后24、72h,两组患者血清VEGF、BFGF均较术前降低,差异有统计学意义(P<0.05);试验组各免疫功能指标优于对照组,差异有统计学意义(P<0.05)。术后24h,两组患者的IgG、IgA、IgM免疫球蛋白水平、中性粒细胞的趋化指数、黏附率、吞噬率、杀菌率、自然杀伤(NK)细胞百分比等免疫学指标均较术前降低,差异有统计学意义(P<0.05);试验组各免疫学指标优于对照组,差异有统计学意义(P<0.05)。术后72h,两组患者IgG、IgA、IgM免疫球蛋白水平、中性粒细胞的趋化指数、黏附率、吞噬率、杀菌率、NK细胞百分比等免疫学指标恢复至术前,差异无统计学意义(P>0.05)。结论索拉菲尼联合TACE治疗老年原发性肝癌,可有效改善患者血清VEGF、BFGF及免疫学指标,但对后者影响持续时间较短,可为临床诊治提供重要参考。

Objective To study the effect of Sola Feeney combined with transcatheter arterial chemoembo lization （TACE） on serum vascular endothelial growth factor （VEGF）,basic fibroblast growth factor （BFGF） and immunological indexes in elderly patients with primary liver cancer,so as to provide reference for clinical diagnosis and treatment. Methods 86 patients with primary liver cancer who were treated in our hospital from October 2011 to October 2016 were selected as the research objects. They were divided into experimental group and control group according to the random number table method,43 cases in each group. The control group was treated with simple TACE,and the experimental group was treated with sola feeney on the basis of the control group. The changes of serum VEGF, BFGF and immunological indexes were compared between the two groups before operation,after operation and after 24,72 h. Results After 24,72 h,the serum VEGF and BFGF of the two groups were lower than those before the operation, the difference was statistically significant （P〈0. 05）, and immunological indexes of the experimental group was better than the control group, the difference was statistically significant （P〈0.05）. After 24 h,the two groups of patients with IgG,IgA,IgM, immunoglobulin level, neutrophil chemotaxis, adhesion rate, phagocytic rate, sterilization rate, percentage of natural killer （NK）cells of immunological index significantly decreased,the difference was statistically signifi-cant （P〈0. 05）;The immunological index of experimental group than the control group,the difference was statistically significant （P〈0.05）. After 72 h,the two groups of patients with IgG,IgA,IgM,immunoglobulin level,neutrophil chemotaxis,adhesion rate,phagocytic rate,sterilization rate,Percentage of NK cells of immu nological index were restored to preoperative, and the difference was not statistically significant （P〉0.05）. Conclusion Sola feeney combined with TACE in the treatment of elderly patients with primary liver cancer can effectively improve the serum VEGF, BFGF and immunological indexes, but the effect on the latter is shorter,which can provide important reference for clinical diagnosis and treatment.