摘要
目的探讨阿德福韦酯联合胸腺肽α1对合并HBV感染肝细胞癌(HCC)患者术后疗效的影响。方法 42例行手术切除的合并HBV感染HCC患者随机分为两组:A组20例,为单纯手术切除;B组22例,为手术切除后加用阿德福韦酯联合胸腺肽α1治疗。观察两组的肝功能、HBVDNA清除率、乙型肝炎e抗原(HBeAg)转阴率、肝癌术后复发时间和生存时间。结果术后6个月B组较A组白蛋白有明显升高(P<0.05),ALT和AST均有明显下降(P<0.05);术后1年B组较A组白蛋白亦有明显升高(P<0.05),总胆红素有明显下降(P<0.05);ALT和AST有极其明显下降(P<0.01)。6个月HBVDNA清除率A组和B组分别为0(0/20)和59.1%(13/22),12个月HBVDNA清除率A组和B组分别为5.0%(1/20)和81.8%(18/22)(P均<0.01);6个月HBeAg转阴率A组和B组分别为0(0/11)和30.8%(4/13),12个月HBeAg转阴率A组和B组分别为9.1%(1/11)和53.8%(7/13)(P均<0.05)。A组和B组的1年复发率分别为75.0%(15/20)和59.1%(13/22)(P>0.05);中位复发时间分别为8.8个月和12.2个月(χ2=3.621,P=0.057)。A组和B组的中位生存时间分别为16.5个月和25.5个月(χ2=6.305,P=0.012)。结论合并HBV感染的HCC患者手术切除术后加用阿德福韦酯联合胸腺肽α1治疗有助于改善患者肝功能状况,提高术后HBVDNA清除率和HBeAg转阴率,推迟肿瘤复发时间,延长患者术后生存期。
Objective To evaluate the effect of postoperative anti-viral therapy using adefovir dipivoxil and thymosin α1 on recurrence of hepatocellular carcinoma with HBV infection.Methods From Jul.2006 to Oct.2008,42 HCC patients with HBV infection were randomized into two groups：Group A （n=20） received hepatectomy only,and Group B（n=22 ） received hepatectomy and postoperative therapy using adefovir dipivoxil and thymosin α1.The changes in liver function,the suppression of HBV-DNA,HBeAg seroconversion rate,tumor recurrence rate and median survival in the two groups were studied comparatively.Results In Group B,serum albumin,total bilirubin,AST and ALT were significantly improved compared with Group A （P〈0.05）.The 6-month HBV-DNA suppression rate in Group A was 0（0/20） vs. 59.1%（13/22）in Group B（P〈0.01）,the 1-year HBV-DNA suppression rate was 5.0%（1/20） vs. 81.8%（18/22）,the 6-month HBeAg seroconversion rate was 0（0/11） vs. 30.8%（4/13）（P〈0.01）,the 1-year HBeAg seroconversion rate was 9.1%（1/11） vs. 53.8%（7/13）（P〈0.01）,the 1-year tumor recurrence rate was 75.0%（15/20） vs. 59.1%（13/22）（P〉0.05）,the median recurrence time was 8.8 vs. 12.2 months （χ^2=3.621,P=0.057 ） and the median survival time was 16.5 vs. 25.5 months （χ^2=6.305,P=0.012）.Conclusions The results suggest that anti-viral therapy using adefovir dipivoxil and thymosin α1 postoperatively may improve the remnant liver function and suppress the HBV reaction,as well as delay the recurrent time and prolong the survival for patients with HCC with HBV infection.
出处
《中华临床医师杂志（电子版）》
CAS
2010年第3期29-32,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
福建省自然科学基金计划资助项目(2006J0325)
关键词
癌
肝细胞
肝炎病毒
乙型
核苷酸类
存活率
Carcinoma
hepatocellular
Hepatitis B virus
Nucleotides
Survival rate
