胸腺肽α1 联合阿帕替尼对原发性肝癌TACE 术后患者免疫功能及疗效的影响

Effect of thymosin α1 combined with Apatinib on immune function and therapeutic effect in patients with primary hepatic carcinoma after TACE

摘要:

目的 研究胸腺肽α1 联合阿帕替尼对经导管动脉栓塞化疗（TACE）术后的原发性肝癌（PHC） 患者免疫功能和疗效的影响。方法 选取2016 年1 月—2018 年4 月于新乡医学院第一附属医院就诊的84 例确诊为PHC 并接受TACE 治疗的患者，使用随机数字表法分为对照组及实验组。所有患者在TACE 术后 第1 天开始口服阿帕替尼，而实验组同时给予胸腺肽α1 治疗。比较两组的免疫功能、肝功能和不良反应。 结果 对照组随访1 年后病死率较实验组高（P <0.05），两组治疗前和治疗后1、3 及6 个月的CD3+、CD4+ 及CD8+ 水平比较，差异有统计学意义（P <0.05），随着治疗时间的延长，患者血清CD3+、CD4+ 水平均呈升 高趋势，血清CD8+ 水平呈下降趋势（P <0.05）。两组患者治疗前和治疗后1、3 及6 个月的ALT 和AST 比较， 差异有统计学意义（P <0.05），随着治疗时间的延长，两组AST 和TBIL 呈降低趋势（P <0.05）。两组治疗后 Child-pugh 分级比较，差异有统计学意义（P <0.05）。实验组疾病控制率较对照组高（P <0.05）。两组患者不 良反应比较，差异无统计学意义（P >0.05）。结论 胸腺肽α1 联合阿帕替尼可显著提高TACE 后PHC 患者 的免疫力和疾病控制率，肝功能恢复效果佳，且无难以控制的不良反应。

Abstract:

Objective To study the effect of thymosin α1 combined with apatinib on immune function and efficacy in patients with primary hepatic carcinoma (PHC) after TACE. Methods From January 2016 to April 2018, 84 patients with primary hepatic carcinoma who underwent TACE at the First Affiliated Hospital of Xinxiang Medical College were randomly divided into the control group and the experimental group. All patients received oral apatinib on the first day after TACE, while the experimental group received thymosin α1 treatment. The immune function, liver function and adverse reactions of the two groups were recorded. Results The mortality of the control group was higher than that of the experimental group after one-year follow-up (P < 0.05). There were statistically significant differences in the levels of CD3+, CD4+ and CD8+ between the two groups before and 1,3 and 6 months after treatment (P < 0.05). With the prolongation of the treatment time, the concentrations of CD3+, CD4+ in the serum of the patients increased, and the levels of CD8+ in the serum decreased (P < 0.05). The difference of ALT and AST between the two groups before and 1, 3 and 6 months after treatment was statistically significant (P < 0.05). There was significant difference in child Pugh between the two groups (P < 0.05). The disease control rate of the experimental group was higher than that of the control group (P < 0.05). There was no significant difference in adverse reactions between the two groups (P > 0.05). Conclusions Thymosin α1 combined with apatinib can significantly improve the immunity and disease control rate of PHC patients after TACE. The effect of liver function recovery is good, and there is no adverse reaction that is difficult to control.