经导管肝动脉化疗栓塞术联合鸦胆子油乳液静脉 滴注对原发性肝癌的疗效及VEGF 水平的影响

Clinical effect of Brucea javanica oil emulsion on TACE in patients with hepatocellular carcinoma and its effect on VEGF levels

摘要:

目的 探讨经导管肝动脉化疗栓塞术（TACE）联合鸦胆子油乳液静脉滴注对原发性肝癌患者的 临床疗效及对血管内皮生长因子（VEGF）表达水平的影响。方法 选取2012 年3 月-2013 年3 月该院收治的 肝癌患者88 例，使用随机数字表法分为研究组及对照组，每组各44 例，对照组患者单用TACE 治疗，研究组 采用TACE 加鸦胆子油乳液静脉滴注。所有患者治疗至少3 个疗程并随访6 ～ 37 个月。比较两组患者治疗后 的临床疗效、不良反应发生率、中位疾病进展时间（TTP）及总生存率，同时比较治疗前后肝功能、血浆内 毒素及VEGF 的水平。结果 观察组的治疗总有效率及中位TTP 高于对照组（P <0.01）；治疗后，观察组的不良 反应发生率低于对照组（P <0.01）；两组肝功能指标、血浆内毒素及VEGF 的水平均升高，但观察组低于对照 组（P <0.01）；两组1 ～ 3 年的总生存率相比差异无统计学意义（P >0.05）。结论 鸦胆子油乳液辅助TACE 治疗原发性肝癌可改善患者的近期疗效和肝功能，延长TPP 时间，降低血浆内毒素、VEGF 的水平，是一种安 全有效的方法。

Abstract:

Objective To evaluate effect of transcatheter arterial chemoembolization (TACE) combined with intravenous drip of Brucea javanica oil emulsion on primary liver cancer. Methods A total of 88 cases of liver cancer from March 2012 to March 2013 were randomized into treatment group (44 cases) and control group (44 cases). Treatment group underwent treatment of TACE plus Brucea javanica oil emulsion infusion, whereas control group underwent TACE alone. All patients underwent three treatment courses and were followed up for 6 to 37 months. Clinical effects, incidence of adverse reactions, median to disease progression time (TTP) and total survival were evaluated. Liver function indexes, plasma endotoxin and VEGF levels before and after treatment were also compared. Results Total effective rate of treatment and median TTP in treatment group were higher than those of control group (P < 0.01). After treatment, Incidence of adverse reactions in treatment group was significantly lower than that of the control group (P < 0.01). Level of liver function index, plasma endotoxin and VEGF increased in both groups, but they were lower in treatment group than in control group (P < 0.01). There was no statistical significance for total survival rate in the two groups (P > 0.05). Conclusion TACE combined with Brucea javanica oil emulsion infusion effectively improves the short-term curative effect and liver function of the patientsand prolongs TPP compared with TACE alone. It can also reduce levels of plasma endotoxin and VEGF.