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目的探究三氧化二砷(As_2O_3)联合经导管动脉化疗栓塞术(TACE)对多结节型或弥漫型原发性肝癌免疫功能及血管内皮生长因子(VEGF)的影响。方法 42例多结节型或弥漫型原发性肝癌患者依据治疗方案分为两组,各21例。对照组用TACE(15 ml超液化碘油+50 mg表柔比星+1.5 g氟尿嘧啶+150 mg奥沙利铂)治疗,研究组在对照组基础上予以As_2O_3治疗。比较两组治疗前后VEGF水平、免疫功能指标(CD3+、CD4+、CD8+、CD4+/CD8+)及生命质量评分。结果治疗后1周两组VEGF水平均升高但无差异(P>0.05),治疗后2周研究组显著降低,对照组持续升高(P<0.05);治疗后两组CD3+均无明显变化(P>0.05),与对照组相比,研究组CD4+、CD4+/CD8+水平均较高,CD8+水平较低(P<0.05);治疗后研究组各领域生命质量评分均优于对照组,躯体功能及自评总分显著高于对照组(P<0.05)。结论As_2O_3联合TACE治疗可显著降低患者VEGF水平,提高免疫功能及生命质量。
Objective To investigate the effect of arsenic trioxide (As_2O_3) combined with transcatheter arterial chemoembolization (TACE) on the immune function and vascular endothelial growth factor (VEGF) in patients with multiple nodular or diffuse primary hepatocellular carcinoma. Methods 42 patients with multi-nodular or diffuse primary liver cancer were divided into two groups according to the treatment plan, 21 cases in each. The control group was treated with TACE (15 ml liquefied lipiodol + 50 mg epirubicin + 1.5 g fluorouracil + 150 mg oxaliplatin). The study group was treated with As 2 O 3 on the basis of the control group. The levels of VEGF, immune function indexes (CD3 +, CD4 +, CD8 +, CD4 + / CD8 +) and quality of life scores of the two groups before and after treatment were compared. Results The levels of VEGF in the two groups increased at one week after treatment, but there was no difference (P> 0.05). The levels of VEGF in the two groups were significantly decreased at 2 weeks after treatment, while those in the control group continued to increase (P <0.05) (P <0.05). Compared with the control group, the levels of CD4 + and CD4 + / CD8 + in the study group were higher and the level of CD8 + was lower (P <0.05). After treatment, the quality of life score of the study group was better than that of the control group The score of function and self-evaluation was significantly higher than that of the control group (P <0.05). Conclusion As 2 O 3 combined with TACE can significantly reduce the level of VEGF in patients and improve the immune function and quality of life.