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目的探讨华蟾素联合化学药物经动脉灌注栓塞(TACE)治疗原发性肝癌的临床价值。方法144例HbsAg阳性肝癌患者,A组76例采用动脉灌注(TAI)华蟾素100 m l、顺铂、5-氟脲嘧啶及阿霉素碘化油乳剂栓塞(TAE);B组68例采用顺铂、5-氟脲嘧啶及阿霉素碘化油乳剂动脉灌注栓塞(TACE)。结果A组有效率(PR+MR)86.84%,淋巴细胞转化率(LTT)、T细胞亚群CD3+、CD4+细胞百分比及CD4+/CD8+比值上升,血清HBV DNA 21例下降、46例不变、9例上升,而外周血白细胞计数无显著变化;1、2年生存率分别为86.84%(66/76)和71.05%(54/76);B组有效率(PR+MR)72.73%,LTT、T细胞亚群CD3+、CD4+细胞百分比及CD4+/CD8+比值下降,血清HBV DNA 2例下降、20例不变、46例上升,外周血白细胞计数下降;1、2年生存率分别72.73%(48/68)和54.41%(37/68)。2组近期有效率、T细胞亚群变化、HBV DNA变化及生存率的差异均有显著意义。结论应用华蟾素联合化学药物经动脉灌注栓塞治疗原发性肝癌,对改善患者生存质量及提高生存期有重要价值。
Objective To investigate the clinical value of cinobufacini combined with chemical drugs in the treatment of primary hepatocellular carcinoma via arterial perfusion and embolization (TACE). Methods A total of 144 patients with HbsAg positive hepatocellular carcinoma were enrolled in this study. A group of 76 patients received TAI Huachansu 100ml, cisplatin, 5-fluorouracil and adriamycin iodinated oil emulsion (TAE) Cisplatin, 5-fluorouracil and doxorubicin iodized oil emulsion arterial perfusion embolization (TACE). Results The effective rate of PR + MR in group A was 86.84%, the rate of lymphocyte transformation (LTT), the percentage of CD3 +, CD4 + cells and the ratio of CD4 + / CD8 increased in T group, 21 cases in serum HBV DNA decreased, 46 cases remained unchanged (P <0.05). The survival rates of one and two years were 86.84% (66/76) and 71.05% (54/76), respectively. The effective rate of PR + MR in group B was 72.73% The percentage of CD3 +, CD4 + cells and the ratio of CD4 + / CD8 in T cell subsets decreased. Serum HBV DNA decreased in 2 cases, unchanged in 20 cases and increased in 46 cases, and the peripheral blood leukocyte count decreased. The 1- and 2-year survival rates were 72.73% 68) and 54.41% (37/68). Two groups of recent efficiency, T cell subsets changes, HBV DNA changes and survival rates were significantly different. Conclusion The application of cinobufacini combined with chemical drugs via arterial infusion embolization in the treatment of primary liver cancer has important value in improving the quality of life and improving the survival of patients.