肝动脉化疗栓塞联合中药治疗BCLC-C期原发性肝癌患者生存期的影响因素分析

Analysis of influencing factors on survival time of patients with hepatocellular carcinoma in BCLC-C stage treated by transcatheter arterial chemoembolization combined with traditional Chinese medicine

目的 探讨肝动脉化疗栓塞(transcatheter arterial chemoembolization, TACE)联合中药治疗巴塞罗那分期(Barcelona Clinic Liver Cancer, BCLC)-C期原发性肝癌(hepatocellular carcinoma, HCC)患者生存期的影响因素。方法选取2017年1月1日至2022年3月31日湖北省中医院BCLC-C期HCC患者56例,根据生存期是否≥22个月分为生存期较长组(18例)和非生存期较长组(38例)。采用多因素logistic回归方程分析TACE联合中药治疗BCLC-C期HCC患者生存期的影响因素。结果 56例BCLC-C期HCC患者中男48例,女8例,年龄31~81岁,平均(59.8±12.5)岁。多因素logistic回归方程分析结果显示,体质量越高(OR=1.125,95%CI:1.014~1.247,P=0.026)、中药汤药服用时间越长(OR=1.004,95%CI:1.000~1.007,P=0.045)、凝血酶原活动度(prothrombin activity, PTA)越高(OR=1.160,95%CI:1.015~1.326,P=0.029)的患者生存期越长。结论 体质量、中药汤药服用时间、PTA是TACE联合中药治疗BCLC-C期HCC患者生存期的影响因素,应及早给予营养支持治疗、中医治疗和改善凝血功能。

Objective To explore the influencing factors of survival time of patients with hepatocellular carcinoma(HCC)in Barcelona Clinic Liver Cancer(BCLC)-C stage treated by transcatheter arterial chemoembolization(TACE)combined with traditional Chinese medicine.Methods A total of 56 patients with HCC in BCLC-C stage in Hubei Provincial Hospital of Traditional Chinese Medicine from January 1,2017 to March 31,2022 were selected and divided into long-term survival group(18 cases)and non-long-term survival group(38 cases)according to whether the survival time was≥22 months.The influencing factors of survival time of the patients treated by TACE combined with traditional Chinese medicine was analyzed by multivariate logistic regression equation.Results Among the 56 patients,there were 48 males and eight females,aged from 31 to 81 years,with an average of(59.8±12.5)years.The results of multivariate logistic regression equation analysis showed that the higher the body weight(OR=1.125,95%CI:1.014-1.247,P=0.026),the longer the taking time of traditional Chinese medicine decoction(OR=1.004,95%CI:1.000-1.007,P=0.045),the higher the prothrombin activity(PTA)(OR=1.160,95%CI:1.015-1.326,P=0.029),the longer the survival time.Conclutions Body weight,taking time of traditional Chinese medicine decoction and PTA are the influencing factors of survival time of patients with HCC in BCLC-C stage treated by TACE combined with traditional Chinese medicine.Nutritional support treatment,traditional Chinese medicine treatment and improvement of coagulation function should be given as soon as possible.