甲磺酸阿帕替尼联合经导管动脉化疗栓塞术对晚期原发性肝癌患者免疫功能及甲胎蛋白水平的影响

Effects of apatinib mesylate combined with transcatheter arterial chemoembolization on immune function and alpha-fetoprotein levels in patients with advanced primary liver cancer

目的探讨甲磺酸阿帕替尼联合经导管动脉化疗栓塞术(TACE)对晚期原发性肝癌患者免疫功能及甲胎蛋白水平的影响。方法选取2021年6月至2022年7月于九江市第一人民医院入院就诊的62例晚期原发性肝癌患者作为研究对象,按照随机数字表法分为对照组与观察组,每组31例。对照组给予单一TACE治疗,观察组给予甲磺酸阿帕替尼联合TACE治疗。比较两组临床疗效、免疫功能指标、甲胎蛋白水平、辅助性T细胞(Th)1型细胞因子水平、不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。治疗后3、6个月,观察组甲胎蛋白水平均低于对照组,差异有统计学意义(P<0.05)。观察组白细胞介素-12(IL-12)、干扰素-γ(INF-γ)、肿瘤坏死因子-α(TNF-α)均水平低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论甲磺酸阿帕替尼联合TACE治疗晚期原发性肝癌可有效改善者免疫功能,降低甲胎蛋白水平,临床疗效显著且安全性好,具有较高的临床应用价值。

Objective To investigate the effects of apatinib mesylate combined with transcatheter arterial chemoembolization(TACE)on immune function and alpha-fetoprotein levels in patients with advanced primary liver cancer.Methods A total of 62 patients with advanced primary liver cancer admitted to Jiujiang First People's Hospital from June 2021 to July 2022 were selected as the research subjects,and they were divided into the control group and the observation group according to random number table method,with 31 cases in each group.The control group was given single TACE treatment,and the observation group was given apatinib mesylate combined with TACE treatment.The clinical efficacy,immune function index,alpha-fetoprotein level,T helper cell(Th)1 cytokine level and occurrence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the level of CD8^(+)was lower than that in the control group,the differences were statistically significant(P<0.05).At 3 and 6 months after treatment,the level of alpha-fetoprotein in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of interleukin-12(IL-12),interferon-γ(INF-γ)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Apatinib mesylate combined with TACE in the treatment of advanced primary liver cancer patients can effectively improve the immune function and reduce the level of alpha-fetoprotein,with significant clinical efficacy and good safety,and has high clinical application value.