TACE术后联合斑蝥酸钠维生素B6治疗原发性肝癌患者近期疗效研究

Venous administration of vitamin B6 sodium cantharidate after TACE in the treatment of patients with primary liver cancer

目的探讨肝动脉灌注化疗栓塞(TACE)术后联合斑蝥酸钠维生素B6治疗原发性肝癌(PLC)患者的近期疗效。方法2019年1月~2022年1月我院收治的84例PLC患者,对照组42例接受TACE治疗,另42例观察组接受TACE术后联合斑蝥酸钠维生素B6静脉滴注治疗,术后随访1年。采用化学荧光法检测血清甲胎蛋白(AFP)水平,采用化学发光免疫分析法检测血清糖类抗原125(CA125)水平,采用直接化学发光法检测血清糖类抗原199(CA199)水平,采用酶法检测血清同型半胱氨酸(Hcy)水平,采用硝酸盐还原法检测血清一氧化氮(NO)水平,采用增强化学发光免疫分析法检测血清内皮素(ET-1)水平。结果观察组完全缓解率、部分缓解率、疾病稳定率和疾病进展率分别为7.1%、42.9%、38.1%和4.8%,而对照组则分别为7.1%、40.5%、19.1%和26.2%,其中观察组疾病稳定率显著高于对照组(P<0.05);治疗后,观察组血清AFP、CA125和CA199水平分别为(540.4±87.1)μg/L、(28.1±9.1)kU/L和(18.0±4.8)kU/L,显著低于对照组【分别为(831.2±94.8)μg/L、(36.0±10.4)kU/L和(24.1±4.6)kU/L,P<0.05】;观察组血清Hcy和ET-1水平分别为(14.1±3.6)μmol/L和(66.1±10.3)ng/L,显著低于对照组【分别为(18.4±4.3)μmol/L和(80.2±12.1)ng/L,P<0.05】;观察组胃肠道反应发生率为16.7%,显著低于对照组的40.5%(P<0.05);两组1 a生存率无显著性差异(84.2%对76.9%,P>0.05)。结论在TACE术后应用斑蝥酸钠维生素B6静脉滴注可以减轻胃肠道反应,并可能改善内皮细胞功能。

Objective This clinical trial was conducted to investigate the efficacy of venous administration of vitamin B6 sodium cantharidate after transhepatic arterial chemoembolization(TACE)in the treatment of patients with primary liver cancer(PLC).Methods 84 patients with PLC were encountered in our hospital between January 2019 and January 2022,and 42 patients in the control received TACE and another 42 patients in the observation were treated by TACE followed by venous administration of vitamin B6 sodium cantharidate for three weeks.All patients in the two groups were followed-up for one year.Serum alpha-fetoprotein(AFP)levels were detected by chemical fluorescence assay,serum carbohydrate antigen 125(CA125)levels were detected by chemiluminescence immunoassay,and serum carbohydrate antigen 199(CA199)levels were detected by direct chemiluminescence assay.Serum homocysteine(Hcy)levels were detected by enzymatic method,serum nitric oxide(NO)levels were assayed by nitrate reduction method,and serum endothelin(ET-1)levels were determined by enhanced chemiluminescence immunoassay.Results The CR,PR,SD and PD in the observation were 7.1%,42.9%,38.1%(P<0.05)and 4.8%,while those in the control were 7.1%,40.5%,19.1%and 26.2%,with the SD significantly different between the two groups;after treatment,serum AFP,CA125 and CA199 levels in the observation group were(540.4±87.1)μg/L,(28.1±9.1)kU/L and(18.0±4.8)kU/L,all significantly lower than[(831.2±94.8)μg/L,(36.0±10.4)kU/L and(24.1±4.6)kU/L,respectively,P<0.05]in the control;serum Hcy and ET-1 levels were(14.1±3.6)μmol/L and(66.1±10.3)ng/L,both much lower than[(18.4±4.3)μmol/L and(80.2±12.1)ng/L,respectively,P<0.05]in the control;the incidence of gastrointestinal reaction in the observation was 16.7%,much lower than 40.5%(P<0.05)in the control;there was no significant difference as respect to the one-year survival in the two groups(84.2%vs.76.9%,P>0.05).Conclusion The venous administration of vitamin B6 sodium cantharidate after TACE in the treatment of patients with PLC could ameliorate gastrointestinal reactions and improve the vascular endothelial functions.