贾金莹

[摘要] 目的 探讨华蟾素联合经肝动脉化疗栓塞（TACE）治疗原发性肝细胞癌（HCC）的临床效果。 方法 选取本院2010年1月～2012年6月收治的95例原发性HCC患者作为研究对象，随机分为联合组和对照组。联合组采用TACE+华蟾素治疗，对照组采用单纯TACE治疗。比较两组的近期疗效、SF-36量表评分和T淋巴细胞功能水平。 结果 联合组的总缓解率为44.90%，显著高于对照组的34.78%，差异有统计学意义（P<0.05）。两组治疗后的PF、RP、BP、GH、VT、SF和RE评分显著高于治疗前，MH评分显著低于治疗前，差异有统计学意义（P<0.05）。联合组治疗后的PF、RP、BP、GH、VT、SF和RE评分显著高于对照组治疗后，MH评分显著低于对照组治疗后，差异有统计学意义（P<0.05）。联合组治疗后的CD3、CD4和CD4/CD8水平显著高于治疗前和对照组治疗后，差异有统计学意义（P<0.05）。 结论 华蟾素联合TACE能够明显改善原发性HCC患者的细胞免疫功能，提高近期疗效，改善生活质量。

[关键词] 原发性肝细胞癌；经导管肝动脉栓塞术；介入治疗；生活质量；细胞免疫

[中图分类号] R735.7 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0052-04

[Abstract] Objective To explore the clinical effect of cinobufagin combined with transhepatic arterial chemotherapy and embolization （TACE） in the treatment of primary hepatocellular carcinoma （HCC）. Methods 95 patients with primary HCC from January 2010 to June 2012 in our hospital were selected and randomly divided into the combination group and the control group.The combination group was treated with cinobufagin conbined with TACE，the control group was treated with TACE.The short-term efficacy，SF-36 scale score and the level of T lymphocyte function in the two groups was compared. Results The total remission rate in the combination group was 44.90%，which was higher than 34.78% in the control group，with significant difference （P<0.05）.The score of PF，RP，BP，GH，VT，SF and RE after treatment in the two groups was higher than that before treatment，the score of MH after treatment in the two groups was lower than that before treatment，with significant difference （P<0.05）.The score of PF，RP，BP，GH，VT，SF and RE after treatment in the combination group was higher than that in the control group after treatment，the score of MH after treatment in the combination group was lower than that in the control group after treatment，with significant difference （P<0.05）.The level of CD3，CD4 and CD4/CD8 after treatment in the combination group was higher than that before treatment and in the control group after treatment，with significant difference （P<0.05）. Conclusion Cinobufagin combined with TACE can significantly improve immune cell function in primary HCC patients，enhance short-term effect and improve the quality of life.

[Key words] Primary hepatocellular carcinoma；Transhepatic arterial chemotherapy and embolization；Interventional therapy；Quality of life；Cellular immunity

原发性肝癌是非常常见的消化系统恶性肿瘤之一，全世界每年新发病例约有60万，位于恶性肿瘤的第五位，而我国肝癌新发病例占全球新发病例的近一半。其主要病理类型为肝细胞癌（hepatocellular carcinoma，HCC）、胆管细胞癌和混合性细胞癌，其中HCC占到了90%以上。HCC多在肝炎病毒感染导致肝硬化的基础上产生，确诊时大多处于中晚期，手术切除率低、预后差[1]。近年来，介入治疗在HCC非手术治疗中发挥着越来越重要的作用，可以明显改善患者的生活质量，延长生存期。本研究旨在探讨华蟾素联合经肝动脉化疗栓塞（transhepatic arterial chemotherapy and embolization，TACE）治疗原发性HCC的临床效果。

1 资料与方法

1.1 一般资料

选取本院普外科2010年1月～2012年6月收治的95例原发性HCC患者作为研究对象，均经临床检查、B超、CT、血清甲胎蛋白（AFP）和穿刺病理确诊。本研究经本院医学伦理委员会批准，参与研究者均知情同意。所有患者均无手术适应证，无远处转移，KPS评分>70分，预计生存期>3个月，Child-Pugh分级1～2级，均有可测量的实体病灶。按照……