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目的探讨脾多肽注射液联合经导管肝动脉化疗栓塞(TACE)治疗中晚期原发性肝癌的临床疗效。方法选取2013年6月至2015年1月在我院接受治疗的中晚期原发性肝癌患者60例,随机分为脾多肽组(脾多肽注射液联合TACE)和对照组(单纯TACE),每组30例。评价并比较两组患者治疗前生活质量(KPS评分)、免疫功能及治疗结束后1个月的临床疗效(RECIST 1.1标准)、KPS评分、免疫功能,记录并比较两组患者的不良反应发生率和生存率。结果脾多肽组的客观有效率(完全缓解+部分缓解)为63.3%(19/30),对照组为33.3%(10/30),两组比较差异有统计学意义(P<0.05)。脾多肽组患者治疗后KPS改善较对照组明显,两组差异有统计学意义(P<0.05)。脾多肽组治疗后CD3~+、CD4~+、CD4~+/CD8~+比值较治疗前提高(P<0.05),而对照组免疫学指标在治疗前后无明显变化。脾多肽组患者的血液毒性和消化道反应等不良反应发生率低于对照组(P<0.05)。脾多肽组与对照组的1年生存率分别为53.3%、43.3%,差异无统计学意义(P>0.05);脾多肽组患者的2年生存率为40.0%,高于对照组的13.3%,差异有统计学意义(P<0.05)。结论脾多肽注射液联合TACE可提高中晚期原发性肝癌患者的临床疗效,延长患者生存期,提高患者的生活质量,并增加患者的免疫功能。
Objective To investigate the clinical efficacy of splenic polypeptide injection combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced primary liver cancer. Methods Sixty patients with advanced primary hepatocellular carcinoma treated in our hospital from June 2013 to January 2015 were randomly divided into splenectomized peptide group (spleen peptide injection combined with TACE) and control group (simple TACE) Group of 30 cases. The quality of life (KPS), immune function and clinical efficacy (RECIST 1.1), KPS score and immune function of the two groups before treatment were evaluated and compared. The incidence of adverse reactions was recorded and compared between the two groups And survival rate. Results The objective effective rate (complete remission + partial remission) of spleen polypeptide group was 63.3% (19/30) and that of control group was 33.3% (10/30). There was significant difference between the two groups (P <0.05). The improvement of KPS in splenic polypeptide group was more obvious than that in control group after treatment, with significant difference between the two groups (P <0.05). The ratio of CD3 ~ +, CD4 ~ +, CD4 ~ + / CD8 ~ + in spleen peptide group was higher than that before treatment (P <0.05), while the immunological index of control group did not change significantly before and after treatment. The incidence of adverse reactions such as hematotoxicity and digestive tract reaction in spleen peptide group was lower than that in control group (P <0.05). The 1-year survival rates of spleen peptide group and control group were 53.3% and 43.3% respectively, with no significant difference (P> 0.05). The 2-year survival rate of spleen polypeptide group was 40.0%, higher than that of control group (13.3% , The difference was statistically significant (P <0.05). Conclusion Splenic polypeptide injection combined with TACE can improve the clinical efficacy of advanced hepatocellular carcinoma in patients with advanced stage, prolong the survival of patients, improve the quality of life of patients and increase the immune function of patients.