不同剂量阿帕替尼联合肝动脉化疗栓塞术对原发性肝癌术后淋巴细胞亚群和肝功能的影响

Effects of Different Doses of Apatinib Combined with Transarterial Chemoembolization on Lymphocyte Subsets and Liver Function after Primary Hepatocellular Carcinoma Surgery

目的:探讨不同剂量阿帕替尼联合肝动脉化疗栓塞术(TACE)对原发性肝癌(HCC)患者术后淋巴细胞亚群和肝功能的影响。方法:选取2021年2月~2022年2月本院收治的HCC行根治术患者98例,采用随机数字表法分为A组和B组,每组49例。A组HCC术后给予250mg阿帕替尼联合TACE;B组HCC术后给予125mg阿帕替尼联合TACE。比较两组患者临床疗效、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)水平和CD4^(+)/CD8^(+)比值)、血清肿瘤标志物[甲胎蛋白(AFP)、磷脂酰肌醇蛋白聚糖-3(GPC3)]、肝功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBiL)]及不良反应。结果:相较于B组,A组客观缓解率和疾病控制率较高(P<0.05);CD3^(+)、CD4^(+)水平和CD4^(+)/CD8^(+)比值均较高(P<0.05);CD8^(+)较低(P<0.05);AFP和GPC3水平较低(P<0.05);ALT、AST和TBiL水平较低(P<0.05)。两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:针对HCC患者根治术后给予阿帕替尼联合TACE,与阿帕替尼150mg相比,250mg可提升患者临床疗效、改善T淋巴细胞亚群、下调血清肿瘤标志物水平、改善肝功能,且不良反应比较无统计学差异。

Objective:To investigate the effects of different doses of apatinib combined with transarterial chemoembolization(TACE)on postoperative lymphocyte subsets and liver function in patients with hepatocellular carcinoma(HCC).Methods:A total of 98 patients with HCC who underwent radical resection in our hospital from February 2021 to February 2022 were selected and randomly divided into group A and group B,49 cases in each group.Group A was given 250 mg of apatinib combined with TACE after surgery,group B received 125 mg apatinib combined with TACE after surgery.The clinical efficacy,T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)ratio),serum tumor markers[alpha-fetoprotein(AFP),glypican-3(GPC3)],liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBiL)]and adverse reactions were compared between the two groups.Results:Compared with group B,the objective remission rate and disease control rate of group A were significantly higher(P<0.05),CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)ratio were significantly higher(P<0.05),and CD8^(+)was significantly lower(P<0.05),the levels of AFP and GPC3 were significantly lower(P<0.05),and the levels of LT,AST and TBiL were significantly lower(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:For HCC patients,apatinib combined with TACE after radical resection,250 mg apatinib can improve the clinical efficacy of patients,improve T lymphocyte subsets,down-regulate serum tumor markers,improve liver function.There was no significant difference in adverse reactions between 250 mg of apatinib and 125 mg of apatinib.