经肝动脉化疗栓塞联合射频消融术和艾迪治疗原发性肝癌患者疗效及其对外周血T淋巴细胞亚群的影响

摘要

目的 探讨采用肝动脉化疗栓塞术(TACE)联合射频消融(RFA)和艾迪注射液治疗原发性肝癌(PLC)患者的疗效及其对外周血淋巴细胞亚群和炎性因子水平的影响.方法 2013年1月~2015年1月收治的76例PLC患者,其中36例接受TACE联合RFA和艾康治疗(观察组),另40例接受TACE和RFA治疗(对照组).采用酶联免疫吸附法测定血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平,使用流式细胞仪测定外周血T细胞亚群.采用Karnofsky评分评估生存质量改善情况.结果 在治疗后3 m末,观察组疾病缓解率为69.4%,与对照组的55.0%比,差异无统计学意义(P>0.05),但观察组疾病控制率为91.7%,显著高于对照组的72.5%(P<0.05);观察组血清CRP、TNF-α和IL-6水平分别为(109.8±13.2)mg/L、(0.5±0.2)pg/mL和(13.4±2.2)pg/mL,均显著低于对照组[(156.2±20.4)mg/L、(1.1±0.2)pg/mL和(24.1±4.4)pg/mL,P<0.05];外周血CD3+和CD4+细胞百分比及CD4+/CD8+比值分别为(60.1±9.7)%、(44.3±8.3)%和(1.9±0.5),均显著高于对照组 [(52.2±9.9)%、(36.30±8.6)%和(1.4±0.3),P<0.05];观察组生存质量改善率为80.5%,显著高于对照组的57.5%(P<0.05);随访24 m,观察组生存28例(77.8%),对照组生存29例(72.5%),差异无统计学意义(P>0.05).结论 采用TACE联合RFA和艾迪注射液治疗PLC患者近期可调节免疫功能,改善患者生活质量,有一定的临床应用价值.%Objective To investigate the efficacy of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA)and Addie injection in the treatment of patients with primary liver cancer(PLC). Methods A total of 76 PLC patients were recruited in our hospital between January 2013 and January 2015,and they were divided into the observation group(n=36)and the control group(n=40),receiving combination of TACE,RFA and Addie and TACE and RFA,respectively. Serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),and peripheral blood lymphocyte subsets were assayed. The quality of life was evaluated by Karnofsky's score. Results There were significant difference in the disease control rate between the observation and the control group(91.7% vs. 72.5%)at the end of 3 month after treatment(P<0.05);serum CRP,TNF-α and IL-6 levels were(109.8±13.2)mg/L,(0.5±0.2)pg/mL and(13.4± 2.2)pg/mL in the observation group,significantly lower than [(156.2±20.4)mg/L,(1.1±0.2)pg/mL and(24.1± 4.4)pg/mL in the control,P<0.05];the percentages of peripheral blood CD3+and CD4+cells and ratio of CD4+/CD8+cells were(60.1±9.7)%,(44.3±8.3)% and(1.9±0.5),respectively,significantly higher than [(52.2±9.9)%, (36.30 ±8.6)% and(1.4 ±0.3)in the control,P<0.05];the improvement rate of quality of life was significantly higher than that in the control group (80.5% vs. 57.5%,P<0.05);at the end of 24 month followed-up,28(77.8%)survived in the observation group,while 29(72.5%)survived in the control(P>0.05). Conclusions Addie injection,a herbal compound,might improve the quality of life in PLC patients receiving TACE and RFA therapy,which might be related to the reduction of inflammatory reaction,and enhance immune functions.