【摘要】 目的观察二甲双胍口服辅助肝动脉化疗栓塞术(TACE)和射频消融术(RFA)治疗晚期原发性肝癌的效果。方法选取晚期原发性肝癌患者120例,随机分为观察组和对照组,各60例。对照组采用TACE联合RFA治疗,观察组在此基础上口服二甲双胍治疗。对比两组的疾病控制率、生存率、肝功能[谷丙转氨酶(ALT)、总胆红素(TBIL)、谷草转氨酶(AST)]、T淋巴细胞亚群比例(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+ T细胞)、生活质量及不良反应发生率。结果术后第6个月,观察组疾病控制率为65.00%,高于对照组的46.67%(P<0.05)。术后第18、24个月,观察组生存率高于对照组(P均<0.05)。术后第7天、第6个月,观察组ALT、AST、TBIL水平均低于对照组(P均<0.05)。术后第6个月,观察组CD3~+、CD8~+、CD4~+/CD8~+T细胞高于对照组,CD8~+T细胞低于对照组(P均<0.05)。术后第1、6个月,观察组生活质量高于对照组(P均<0.05)。两组术后不良反应发生率比较差异无统计学意义。结论二甲双胍口服可改善接受TACE和RFA治疗的晚期原发性肝癌患者的肝功能,提高患者免疫功能及生活质量,且较安全。更多还原

【Abstract】 Objective To observe the effect of oral metformin in assisting transcatheter arterial chemoembolization(TACE) and radiofrequency ablation(RFA) in the treatment of advanced primary liver cancer. Methods Totally 120 patients with advanced primary liver cancer were selected, and then were randomly divided into the observation group and control group, with 60 cases in each. The patients in the control group were treated with TACE and RFA, and the patients in the observation group were administered metformin on the basis of TACE and RFA. The disease control rate, survival rate, liver function [Alpha-alanine aminotransferase(ALT), aspertate aminotransferase(AST) and total bilirubin(TBIL)], T-lymphocyte subsets(CD3~+, CD4~+, CD8~+, CD4~+/CD8~+ T cells), quality of life, and incidence of adverse reactions were compared between these two groups. Results At 6 th month after operation of TACE combined RAF, the disease control rate in the observation group was 65.00%, which was higher than that(46.67%) in the control group(P<0.05). The survival rate of the observation group was higher than that of the control group at 18 and 24 months after operation of TACE combined RAF(all P<0.05). On the 7 th day and 6 th month after TACE combined RAF, the levels of ALT, AST and TBIL in the observation group were lower than those in the control group(all P<0.05). At the 6 th month after TACE combined RAF, the CD3~+, CD8~+, and CD4~+/CD8~+ T cells in the observation group were higher than those in the control group, and the CD8+ T cell was lower than that in the control group(all P<0.05). The quality of life in the observation group was higher than that in the control group at the 1 st and 6 th month after operation(all P<0.05). There was no significant difference in the incidence of adverse events between the two groups(P>0.05). Conclusion Oral metformin can improve liver function in patients with advanced primary liver cancer treated with TACE and RFA, and it can improve the immune function and quality of life of patients and is much safer.更多还原