恩替卡韦联合肝动脉化疗栓塞治疗乙型肝炎病毒相关性不可切除肝癌患者的疗效观察

Curative effect of entecavir combined with TACE on HBV related unresectable liver cancer

目的探讨恩替卡韦联合肝动脉化疗栓塞(TACE)治疗乙型肝炎病毒(HBV)相关性不可切除肝癌患者的临床疗效。方法选取南阳医学高等专科学校第一附属医院自2014年1月至2015年6月收治的HBV相关性不可切除肝癌患者60例作为研究对象,按照治疗方案的不同,分为观察组和对照组,每组30例。观察组术后给予恩替卡韦联合TACE进行治疗,对照组给予TACE治疗,连续治疗3个月后,对两组患者丙氨酸氨基转移酶(ALT)、乙肝病毒的脱氧核糖核酸(HBV-DNA)水平及Child Pugh评分进行比较,并对两组患者的近期疗效进行评价。结果治疗3个月后,两组相关指标ALT、HBV-DNA水平及Child Pugh评分比较,差异有统计学意义(t=5.514 5、5.005 8、5.346 8,P=0.005、0.007、0.000 6);观察组客观缓解率(ORR)为46.67%,对照组为20.00%,观察组疾病控制率(DCR)为80.00%,对照组为50.00%,两组ORR和DCR比较,差异有统计学意义(χ~2=4.800、5.934,P=0.028、0.015)。结论对HBV相关性不可切除肝癌患者进行恩替卡韦联合TACE治疗有助于改善患者肝脏功能,并减缓疾病进展,值得临床推广应用。

Objective To explore the curative effect of entecavir combined with transcatheter arterial chemoembolization（ TACE） on hepatitis B virus（ HBV） related unresectable liver cancer. Methods Sixty patients with HBV related unresectable liver cancer were selected in Nanyang Medical College First Affiliated Hospital from January 2014 to June 2015. According to the different therapies,patients were assigned into the observation group（ n = 30） and the control group（ n = 30）. The observation group had a treatment of entecavir combined with TACE,while the control group was given TACE treatment. Alanine transaminase（ ALT）,desoxyribonucleic acid of HBV（ HBV-DNA） level and Child Pugh score of two groups were compared after three-month continuous treatment. The short term efficacies of two groups were evaluated. Results After 3 months of treatment,ALT,HBV-DNA level and Child-Pugh score of two groups were compared,the differences were statistically significant（ t = 5. 514 5,5. 005 8,5. 346 8,P = 0. 005,0. 007,0. 000 6）. The objective response rates（ ORR） were 46. 67% in the observation group and 20. 00% in the control group. The disease control rates（ DCR） was80. 00% in the observation group and 50. 00% in the control group. There were statistically significant differences in ORR and DCR between two groups（ χ-2= 4. 800,5. 934,P = 0. 028,0. 015）. Conclusion Ntecavir combined with TACE for treating HBV related unresectable liver cancer helps to improve liver function and slow disease progression,which has clinical application value.