TACE联合胸腺肽α1治疗原发性肝癌的临床疗效

Clinical Efficacy of TACE Combined with Thymidineα1 in the Treatment of Primary Liver Cancer

目的探索胸腺肽α1联合TACE治疗原发性肝癌患者的临床疗效。方法将新乡医学院第三附属医院2020年1月至2021年12月期间收治的原发性肝癌患者83例作为研究对象,采用随机数字表法将患者分为观察组(N=42例)和对照组(N=41例),对照组患者接受常规TACE治疗,观察组在对照组基础上联合胸腺肽α1治疗,4周后比较两组患者治疗后临床有效率,不良反应发生率,医院感染率,菌株鉴定结果及治疗前后T细胞亚群(CD8^(+),CD4^(+),CD3^(+))和自然杀伤细胞(NK)数量。结果观察组临床有效率为80.95%,高于对照组的65.85%,差异有统计学意义(χ^(2)=7.854,P<0.05)。两组不良反应发生率差异无统计学意义(χ^(2)=0.058,P>0.05)。观察组感染率为9.52%低于对照组的19.51%,差异有统计学意义(χ^(2)=6.742,P<0.05)。观察组感染的4例患者中共检出粪肠球菌1株,金黄色葡萄球菌2株,铜绿假单胞菌1株,肺炎克雷伯菌1株,大肠埃希菌3株;对照组感染的8例患者中共检出粪肠球菌1株,金黄色葡萄球菌2株,铜绿假单胞菌1株,肺炎克雷伯菌2株,大肠埃希菌3株,白假丝酵母2株。治疗前两组CD8^(+),CD4^(+),CD3^(+),NK细胞数量无明显差异,干预后对照组CD8^(+)T细胞数量增加,CD4^(+)、CD3^(+)T细胞数量及NK细胞数量降低;观察组CD8^(+)T细胞数量降低,CD4^(+)、CD3^(+)T细胞数量及NK细胞数量增加,和同组治疗前比较差异均有统计学意义(均P<0.05),治疗后两组间比较发现观察组CD8^(+)T细胞数量低于对照组,CD4^(+)、CD3^(+)T细胞数量及NK细胞数量高于对照组,差异有统计学意义(均P<0.05)。结论TACE治疗肝癌患者增加胸腺肽α1治疗后可以提高临床疗效,改善患者免疫功能,有助于预防感染,值得应用。

Objective To explore the clinical efficacy of thymosinα1 combined with TACE in the treatment of patients with primary liver cancer.Methods A total of 83 patients with primary liver cancer admitted to the Third Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2021 were selected as the research objects.The patients were divided into observation group(N=42)and control group(N=41)by random number table method.Patients in the control group received conventional TACE treatment,and the observation group was treated with thymidineα1 on top of the control group.After 4 weeks,the clinical efficiency,incidence of adverse reactions,hospital infection rate,strain identification results and the number of T cell subsets(CD8,CD4,CD3)and natural killer cells(NK)before and after treatment were compared between the two groups.Results The clinical effective rate of the observation group was 80.95%,which was higher than that of the control group(65.85%),and the difference was statistically significant(χ^(2)=7.854,P<0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(χ^(2)=0.058,P>0.05).The rate of infection in the observation group was 9.52%lower than that in the control group,19.51%,and the difference was statistically significant(χ^(2)=6.742,P<0.05).A total of 1 strain of Enterococcus faecalis,2 strains of Staphylococcus aureus,1 strain of Pseudomonas aeruginosa,1strain of Klebsiella pneumoniae,and 3 strains of Escherichia coli were detected in the 4 patients infected in the observation group;1 strain of Enterococcus faecalis,2 strains of Staphylococcus aureus,1 strain of Pseudomonas aeruginosa,2 strains of Klebsiella pneumoniae,3 strains of Escherichia coli,and 2 strains of Pseudomonas albicans were detected in the 8 patients infected in the control group.There was no significant difference in the number of CD8,CD4,CD3,and NK cells between the two groups before treatment,and after intervention,the number of CD8T cells increased and the number of CD4,CD3T cells and NK cells decreased in the control group;the number of CD8T cells decreased and the number of CD4,CD3T cells and NK cells increased in the observation group,and the differences were statistically significant when compared with the same group before treatment The differences were statistically significant(all P<0.05),and the comparison between the two groups after treatment revealed that the number of CD8T cells in the observation group was lower than that in the control group,and the number of CD4,CD3T cells and NK cells were higher than that in the control group,with statistically significant differences(all P<0.05).Conclusion TACE treatment for hepatocellular carcinoma patients with the addition of thymidineα1 therapy can improve clinical efficacy,improve patients’immune function and help prevent infection,which is worth applying.