加用N-乙酰半胱氨酸对行TACE的HCC患者术后的影响

Influence of N-acetylcysteine on hepatocellular carcinoma patients undergoing TACE

目的探讨对行肝动脉化疗栓塞术(TACE)的原发性肝癌(HCC)患者采用N-乙酰半胱氨酸(NAC)治疗的效果。方法将72例行TACE的HCC患者分成两组,在常规措施的基础上,对照组给予甘草酸二铵注射液治疗,观察组加用NAC治疗,观察患者氧化应激、T淋巴亚群和肝功能指标的变化。结果治疗4周后,观察组的血清超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平显著升高,丙二醛(MDA)和CD8^(+)水平显著降低(P<0.05);观察组ALT和TBil水平显著低于对照组(P<0.05),两组ALB和FIB水平无差异(P>0.05)。两组不良反应比较无显著差异(P>0.05)。结论NAC能抑制TACE患者的氧化应激水平,调节机体的细胞免疫功能,改善肝功能,安全性较高。

Objective To investigate the therapeutic effect of N-acetylcysteine(NAC)in hepatocellular carcinoma(HCC)patients undergoing transcatheter arterial chemoembolization(TACE).Methods Seventy-two HCC patients undergoing TACE were divided into 2 groups.On the basis of conventional therapy,the control group was treated with diammonium glycyrrhizinate intravenous infusion,and the observation group was treated with NAC.The changes of oxidative stress,T lymphatic subsets and liver function indexes were recorded.Results After 4-week treatment,the levels of serum superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px),CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were significantly increased,while the levels of malondialdehyde(MDA)and CD8^(+)in observation group were significantly decreased(P<0.05).The levels of alanine aminotransferase(ALT)and total bilirubin(TBIL)in observation group were significantly lower than those in control group(P<0.05).There was no significant difference in the levels of albumin(ALB)and fibrinogen(FIB)between the 2 groups(P>0.05).There was no significant difference in adverse drug reactions(ADR)between the 2 groups(P>0.05).Conclusion NAC can inhibit the oxidative stress level,regulate cellular immune function and improve the liver function of HCC patients undergoing TACE,and it has high safety.