王波 王友清 毛魁 陈龙 孙维建

[摘要] 目的 探讨参麦注射液对动脉灌注化疗肝癌患者微血管密度及生存质量的影响。 方法 收集临海市第一人民医院和温州医科大学附属第二医院2015年1月～2017年1月经动脉灌注化疗治疗的原发性肝癌（HCC）患者90例，按照随机数字表法分为对照组及观察组，每组各45例。所有患者均接受动脉灌注化疗治疗，观察组在对照组的基础上给予参麦注射液。分析血管内皮生长因子（VEGF）及微血管密度（MVD）的免疫组织化学表达，并评价其生存质量。 结果 两组肝癌组织VEGF及MVD阳性染色深浅不均，对照组染色深，观察组较浅；观察组的肝癌组织VEGF和MVD表达均明显低于对照组，差异有高度统计学意义（P < 0.01）；观察组的整体生存质量优于对照组，差异有统计学意义（P < 0.05）。 结论 参麦注射液可明显改善动脉灌注化疗肝癌患者预后，有效抑制肝癌组织VEGF表达，降低肝癌组织的血管密度及MVD，从而抑制肿瘤血管生成，提高生存质量，值得推广。

[关键词] 参麦注射液；微血管密度；生存质量；动脉灌注化疗；肝癌

[中图分类号] R735.7 [文献标识码] A [文章编号] 1673-7210（2018）06（b）-0123-05

[Abstract] Objective To explore the effect of Shenmai Injection on microvascular density and quality of life of hepatic carcinoma（HCC） patients with arterial infusion chemotherapy. Methods From January 2015 to January 2017， in the First People's Hospital of Linhai City and the Second Affiliated Hospital of Wenzhou Medical University， 90 HCC patients treated with arterial infusion chemotherapy were collected， according to random number table method， patients were divided into control group and observation group， with 45 cases in each group， all patients were treated with arterial perfusion chemotherapy， the observation group was given Shenmai injection on the basis of the control group， immunohistochemical expression of VEGF and MVD were analyzed， and the quality of life was evaluated. Results The positive staining was not uniform of VEGF and MVD in the two groups， and the control group was darker， and the observation group was shallower. The expression of VEGF and MVD in HCC in the observation group was significantly lower than that in the control group， and the differences were statistically significant （P < 0.01）. The overall quality of life of the observation group was better than that of the control group， the difference was statistically significant （P < 0.05）. Conclusion Shenmai Injection can obviously improve the prognosis of hepatic carcinoma patients with arterial infusion chemotherapy， effectively restrain VEGF expression of the liver tissue， reduce the density of blood vessels and MVD， thereby inhibit tumor angiogenesis， improve the quality of life， which is worth promoting.

[Key words] Shenmai Injection； Microvascular density； Quality of life； Arterial infusion chemotherapy； Hepatic carcinoma

原发性肝癌（hepatocellular carcinoma，HCC）是我国常见的恶性肿痛之一[1]。随着医疗水平不断进步，早发现、早诊断使得部分患者肿瘤得以手术切除，疗效较好，但早期诊断的工作不很普遍，大部分患者在确诊时已经是“大肝瘤”，或由于肝内播散不能切除，或由于肿瘤过大不能切除，或由于紧贴大血管无法切除，此时需要非手术治疗[2-3]。肝动脉灌注化疗作为肝癌术后治疗及不能切除的晚期肝癌患者的重要治疗手段，其能够显著减少药物在外周血和其他部位的分布，提高药物在肝组织中的浓度[4]。通过化疗来抑制肿瘤血管生成虽然是抗肿瘤的重要作用机制，但毒副作用大，生存期一般在3个月左右，動脉灌注化疗1年生存率不足30%[5-6]。……