替比夫定联合TACE治疗合并肝硬化的中晚期原发性肝癌的临床研究

摘要

Objective It is to approach the therapeutic effects of telbivudine combined with transcatheter arterial chemoem-bolization ( TACE ) in treatment of advanced hepatocellular carcinoma ( HCC ) patients with HBV DNA positive cirrhosis. Methods 55 advanced HCC patients with HBV DNA positive cirrhosis were divided into treatment group ( 28 cases ) for TACE plus telbivudine and control group ( 27 cases ) for TACE alone. The liver function Child-pugh points of patients, HBV DNA quantification and 2-year survival rate were observed and compared between both groups. Results One year and two years later, the liver function Child-pugh points in treatment group were significantly lower than that in control group ( all P < 0.05 ), the HBV DNA negative rate of treatment group were significantly higher than that of control group ( all P < 0. 01 ), 2 - year survival rates were 61% in treatment group and 33% in control group ( P <0. 05 ). Conclusion TACE combined with telbivudine in HBV DNA positive patients with advanced liver cirrhosis and HCC, can inhibit HBV replication, improve liver function, and increase the survival rate.%目的 探讨替比夫定联合经皮肝动脉栓塞化疗术(TACE)治疗HBV DNA阳性的合并肝硬化的中晚期原发性肝细胞癌(HCC)患者的疗效.方法 将55例HBV DNA阳性的合并肝硬化的中晚期HCC患者随机分为TACE+替比夫定治疗组(28例),单纯TACE对照组(27例),观察比较2组患者肝功能Child-pugh积分、HBV DNA定量及2a生存率.结果 治疗1a及2a后,肝功能Child-pugh积分治疗组明显小于对照组(均P<0.05);治疗组HBV DNA转阴率均显著高于对照组(均P<0.01);治疗组和对照组2a生存率分别为61%和33%(P<0.05).结论 TACE联合替比夫定治疗HBV DNA阳性的合并肝硬化的中晚期HCC患者,可抑制乙肝病毒复制,改善患者肝功能,提高生存率.