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目的随机对照研究动脉内重组人血管内皮抑制素(恩度TMEndostarTM)联合化疗栓塞(TACE)治疗原发性肝癌(HCC)前后CT灌注参数的变化。资料与方法40例临床诊断为HCC的患者,随机分成两组,各20例,分别使用动脉内恩度加TACE术及单纯TACE术,所有病例于TACE术前、术后1个月行CT灌注成像(CTPI)扫描,测量肿瘤组织治疗前后血流量(BF)、血容量(BV)、血管表面渗透面积(PS)、肝动脉灌注值(ALP)、门静脉灌注值(PVP)及肝脏灌注指数(HPI)。结果动脉内恩度加TACE术组HCC患者术后1个月CTPI扫描肿瘤组织BF、ALP及HPI水平较术前降低,PVP水平较术前升高,BV、PS水平与术前相比无显著性差异;单纯TACE术组HCC患者术后1个月ALP水平较术前降低,PVP水平较术前升高,BV、BF、PS及HPI水平与术前相比无显著性差异。结论通过比较两组HCC患者TACE前后CT灌注参数的变化,说明恩度对肿瘤血管生成有一定的抑制作用。
Objective To study the changes of CT perfusion parameters before and after the treatment of primary hepatocellular carcinoma (HCC) with intra-arterial recombinant human endostatin (Endostar TM) combined with chemoembolization (TACE). Materials and Methods 40 patients with clinically diagnosed HCC were randomly divided into two groups (n = 20 in each group). Arterial endocardial TACE (TACE) and simple TACE were performed. All patients underwent CT perfusion before TACE and one month after surgery (CTPI) was used to measure the changes of blood flow (BF), blood volume (BV), blood vessel surface area (PS), hepatic artery perfusion value (ALP), portal vein perfusion (PVP) and hepatic perfusion index HPI). Results The levels of BF, ALP and HPI in CTPI-treated HCC patients at 1 month after operation were lower than those before operation and the levels of PVP and BV were not significantly different from preoperative There was no significant difference in the levels of BV, BF, PS and HPI between HCC patients and TACE patients at 1 month after operation. Conclusion Comparing the changes of CT perfusion parameters before and after TACE in two groups of HCC patients shows that Endue has a certain inhibitory effect on tumor angiogenesis.