摘要
目的探讨小剂量阿帕替尼联合肝动脉化疗栓塞术(TACE)治疗肝细胞癌(HCC)合并门静脉癌栓(PVTT)的疗效及对血清细胞凋亡相关因子半胱氨酰天冬氨酸蛋白酶8(caspase-8)、血管内皮生长因子(VEGF)的影响。方法选取2015年2月—2018年7月本院收治的HCC合并PVTT患者120例作为研究对象,根据随机数表法分为A组和B组两组,每组各60例。A组给予TACE治疗,B组给予小剂量阿帕替尼联合TACE治疗,对比两组疗效、血清VEGF、caspase-8水平及不良反应、平均生存时间。结果 B组的临床总有效率为60.00%(36/60),高于对照组的40.00%(24/60)(P<0.05)。两组治疗后血清VEGF水平降低,caspase-8水平升高(P<0.05),B组治疗后血清VEGF水平低于A组,caspase-8水平高于A组(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。B组的中位生存时间长于A组(P<0.05)。结论小剂量阿帕替尼联合TACE治疗HCC合并PVTT患者,可有效调节血清VEGF、caspase-8水平,提高患者中位生存时间,且不增加不良反应发生率。
Objective To investigate the curative effect of small dose of apatinib combined with transcatheter arterial chemoembolization(TACE)in the treatment of hepatocellular carcinoma(HCC)complicated with portal vein tumor thrombus(PVTT)and its influence on serum vascular endothelial growth factor(VEGF)and apoptosis related factors cysteine aspartate protease-8(caspase-8).Methods 120 patients with HCC complicated with PVTT who were admitted in our hospital from February 2015 to July 2018 were selected as study subjects,they were divided into group A and group B according to the random number table method,60 cases in each group.Patients in group A were treated with TACE,and group B was treated with low-dose apatinib combined with TACE.The curative effect,serum VEGF,caspase-8 levels and adverse reactions,average survival time of the two groups were compared.Results The total effective rate of group B was 60.00%(36/60),which was higher than 40.00%(24/60)of control group(P<0.05).Serum VEGF level decreased,caspase-8 level increased in both groups after treatment(P<0.05),serum VEGF level in group B was lower than that of group A,and caspase-8 level was higher than that of group A after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The median survival time of group B was longer than that of group A(P<0.05).Conclusions Small dose of apatinib combined with TACE in the treatment of HCC patients with PVTT could effectively improve the median survival time of patients,effectively regulate the serum VEGF,Caspase-8 levels,and does not increase the incidence of adverse reactions.
作者
张程鹏
范爱云
汤雪松
ZHANG Cheng-peng(Department of Intervention,Xinxiang Alliance Hospital,XinXiang,Henan,453800,China)
出处
《齐齐哈尔医学院学报》
2021年第2期132-135,共4页
Journal of Qiqihar Medical University
关键词
阿帕替尼
肝动脉化疗栓塞术
肝细胞癌
门静脉癌栓
Apatinib
Transcatheter arterial chemoembolization
Hepatocellular carcinoma
Portal vein tumor thrombus
