标题：TACE联合局部注入恩度乳剂治疗中晚期肝癌疗效评价

      作者：林福煌，林碧泉，吴宁，李斯锐，陈峰，陈美丹    (海南省人民医院放射介入科，海南 海口 570311)

      卷次： 2017年28卷12期

      【摘要】 目的 探讨肝动脉化疗栓塞术(TACE)联合局部注入重组人血管内皮抑制素(恩度)乳剂治疗中晚期肝癌的临床疗效。方法 选取2015年1月至2016年8月在我院收治的中晚期肝癌患者52例，按随机数表法分为对照组和观察组，每组26例，其中对照组仅采用TACE治疗，观察组采用TACE联合局部恩度乳剂注入治疗。疗程结束后比较两组患者的临床疗效、甲胎蛋白(AFP)转阴率、血管内皮生长因子(VEGF)的表达和不良反应，并对观察组患者治疗前后的凝血功能进行比较。结果 观察组患者的治疗总有效率为65.38%，AFP转阴率为42.31%，均高于对照组的30.77%和15.38%，差异均有统计学意义(P<0.05)；两组患者术后第3天和第7天的血清VEGF表达水平均先升后降，观察组患者的表达水平分别为(446.41±114.68) pg/mL和(306.37±106.63) pg/mL，对照组分别为(487.84±103.64) pg/mL和(436.83±113.12) pg/mL，观察组均低于对照组，差异均有统计学意义(P<0.05)；观察组患者治疗前后的凝血功能以及不良反应比较差异均无统计学意义(P>0.05)。结论 TACE联合局部注入恩度乳剂治疗中晚期肝癌的疗效优于单纯的TACE治疗，且安全、不良反应少，值得临床应用推广。
      【关键词】 肝细胞癌；恩度；肝动脉化疗栓塞术；临床疗效
      【中图分类号】 R735.7 【文献标识码】 A 【文章编号】 1003—6350（2017）12—1905—03

Therapeutic evaluation of TACE combined with local injection endostatin emulsifier in the treatment of advancedliver cancer.
LIN Fu-huang, LIN Bi-quan, WU Ning, LI Si-rui, CHEN Feng, CHEN Mei-dan. Department ofInterventional Radiology, People's Hospital of Hainan Province, Haikou 570311, Hainan, CHINA
【Abstract】 Objective To explore the clinical effect of transcatheter arterial chemoembolization (TACE) com-bined with local injection endostatin emulsifier in the treatment of advanced liver cancer patients. Methods A total of52 patients with advanced liver cancer, who admitted to our hospital from January 2015 to August 2016, were selectedand randomly divided into the observation group and the control group according to the random digital table method,with 26 cases in each group. The control group was intervened with the single TACE therapy, and the observation groupwas treated with TACE combined with local injection endostatin emulsifier. At the end of the course of treatment, theclinical efficacy, rate of alpha-fetoprotein (AFP), expression of vascular endothelial growth factor (VEGF) and adversereactions of the two groups were compared. The coagulation function was compared before and after the treatment in theobservation group. Results The total efficacy rate and AFP negative rate of the observation group were 65.38% and42.31%, respectively, which were significantly higher than 30.77% and 15.38% in control group (P<0.05). The serumlevel of VEGF expression of the two groups at third and seventh day after the operation were subjected to the process ofincreased first and decreased afterward, and the expression levels in the observation group were (446.41±114.68) pg/mLand (306.37±106.63) pg/mL, respectively, which were significantly lower than (487.84±103.64) pg/mL and (436.83±113.12) pg/mL in the control group (P<0.05). There was no significant difference between before and after the treatmentin the observation group in coagulant function and adverse reactions (P>0.05). Conclusion The efficacy of TACE com-bined with local injection endostatin emulsifier chemotherapy in the treatment of advanced liver cancer is better thanpure TACE, which also has the advantages of safe and less adverse reactions, and is worthy of clinical application.
      【Key words】 Hepatocellular carcinoma; Endostatin; Transcatheter arterial chemoembolization (TACE); Clinicaleffect·论 著·doi:10.3969/j.issn.1003-6350.2017.12.004基金项目：海南省医药卫生科研项目（编号：14A210248）；海南省社会发展科技专项项目资助（编号：2015SF02）