临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2015年
5期
721-724
,共4页
李鹏%翟云%张世斌%李磊%丁惠国
李鵬%翟雲%張世斌%李磊%丁惠國
리붕%적운%장세빈%리뢰%정혜국
肝炎病毒,乙型%癌,肝细胞%预后
肝炎病毒,乙型%癌,肝細胞%預後
간염병독,을형%암,간세포%예후
hepatitis B virus%carcinoma,hepatocellular%prognosis
目的：探讨 HBV 相关终末期肝细胞癌（HCC）患者在内科保肝等治疗方案的基础上联合抗 HBV 治疗的获益情况。方法收集2011年1月－2012年1月于北京佑安医院就诊的初次诊断乙型肝炎肝硬化基础上的晚期 HCC 患者105例，根据治疗方案不同分为常规治疗组（A 组，n ＝44）和抗病毒治疗组（B 组，n ＝61），随访96周，通过 Karnofsky 评分、Child －Pugh 评分、MELD 评分及生存率的比较，评价患者受益情况。计量资料组间比较采用 t 检验，计数资料组间比较采用χ2检验，预后分析采用 Kaplan －Meier生存分析。结果随访至治疗24周时，B 组患者的一般情况及肝功能与 A 组相比改善明显，Karnofsky 评分明显提高（t ＝4．785， P ＝0．031），Child －Pugh 评分明显降低（t ＝5．015，P ＝0．028）；至96周时，B 组患者 Karnofsky 评分（t ＝8．578，P ＝0．016）、Child －Pugh 评分（t ＝6．774，P ＝0．021）、MELD 评分（t ＝9．014，P ＝0．008）与同期 A 组患者相比明显改善；随访96周时 B 组患者生存率显著高于 A 组，差异具有统计学意义（67．2％ vs 45．5％，P ＝0．026）。结论给予 HBV 相关终末期 HCC 患者有效抗病毒治疗能够提高患者生存质量、改善肝功能、减少并发症、延长其生存期，从而使患者获益。
目的：探討 HBV 相關終末期肝細胞癌（HCC）患者在內科保肝等治療方案的基礎上聯閤抗 HBV 治療的穫益情況。方法收集2011年1月－2012年1月于北京祐安醫院就診的初次診斷乙型肝炎肝硬化基礎上的晚期 HCC 患者105例，根據治療方案不同分為常規治療組（A 組，n ＝44）和抗病毒治療組（B 組，n ＝61），隨訪96週，通過 Karnofsky 評分、Child －Pugh 評分、MELD 評分及生存率的比較，評價患者受益情況。計量資料組間比較採用 t 檢驗，計數資料組間比較採用χ2檢驗，預後分析採用 Kaplan －Meier生存分析。結果隨訪至治療24週時，B 組患者的一般情況及肝功能與 A 組相比改善明顯，Karnofsky 評分明顯提高（t ＝4．785， P ＝0．031），Child －Pugh 評分明顯降低（t ＝5．015，P ＝0．028）；至96週時，B 組患者 Karnofsky 評分（t ＝8．578，P ＝0．016）、Child －Pugh 評分（t ＝6．774，P ＝0．021）、MELD 評分（t ＝9．014，P ＝0．008）與同期 A 組患者相比明顯改善；隨訪96週時 B 組患者生存率顯著高于 A 組，差異具有統計學意義（67．2％ vs 45．5％，P ＝0．026）。結論給予 HBV 相關終末期 HCC 患者有效抗病毒治療能夠提高患者生存質量、改善肝功能、減少併髮癥、延長其生存期，從而使患者穫益。
목적：탐토 HBV 상관종말기간세포암（HCC）환자재내과보간등치료방안적기출상연합항 HBV 치료적획익정황。방법수집2011년1월－2012년1월우북경우안의원취진적초차진단을형간염간경화기출상적만기 HCC 환자105례，근거치료방안불동분위상규치료조（A 조，n ＝44）화항병독치료조（B 조，n ＝61），수방96주，통과 Karnofsky 평분、Child －Pugh 평분、MELD 평분급생존솔적비교，평개환자수익정황。계량자료조간비교채용 t 검험，계수자료조간비교채용χ2검험，예후분석채용 Kaplan －Meier생존분석。결과수방지치료24주시，B 조환자적일반정황급간공능여 A 조상비개선명현，Karnofsky 평분명현제고（t ＝4．785， P ＝0．031），Child －Pugh 평분명현강저（t ＝5．015，P ＝0．028）；지96주시，B 조환자 Karnofsky 평분（t ＝8．578，P ＝0．016）、Child －Pugh 평분（t ＝6．774，P ＝0．021）、MELD 평분（t ＝9．014，P ＝0．008）여동기 A 조환자상비명현개선；수방96주시 B 조환자생존솔현저고우 A 조，차이구유통계학의의（67．2％ vs 45．5％，P ＝0．026）。결론급여 HBV 상관종말기 HCC 환자유효항병독치료능구제고환자생존질량、개선간공능、감소병발증、연장기생존기，종이사환자획익。
Objective To investigate the acquired benefit of antiviral therapy in addition to routine treatment regimen including hepatopro-tective internal medicine in patients with hepatitis B virus (HBV)-related end -stage hepatocellular carcinoma (HCC).Methods A to-tal of 105 end -stage HCC patients who were admitted to our hospital from January 2011 to January 2012 with an initial diagnosis of hepatitis B cirrhosis were included in this study.According to the treatment regimen,the patients were divided into routine treatment group (group A)and antiviral therapy group (group B).Patients were followed up for 96 weeks,and the benefit of antiviral therapy was evaluated by comparison of Karnofsky score,Child -Push score,Model for End -Stage Liver Disease (MELD)score,and survival rate between two groups.Comparison of continuous data between groups was made by t test,and comparison of categorical data was made by χ2 test.Prognos-tic analysis was made by Kaplan -Meier survival analysis.Results At week 24 of follow -up,patients in group B had markedly improved general status and liver function,significantly increased Karnofsky score (t =4.785,P =0.031 ),and significantly reduced Child -Push score (t =5.015,P =0.028)compared with those in group A.At week 96,the Karnofsky score,Child -Push score,and MELD score all showed significant improvements in group B compared with those in group A (t =8.578,P =0.016;t =6.774,P =0.021;t =9.014,P =0.008).The patients in group B had a significantly higher survival rate than those in group A (67.2% vs 45.5%,P =0.026).Conclu-sion Effective antiviral therapy in patients with HBV -related end -stage HCC could improve the quality of life and liver function,reduce complications,prolong the survival time,and thus bring great benefits to those patients.
