CAJ | 학술논문

目的：探讨肝动脉化疗栓塞术（TACE）在艾滋病合并肝癌患者中的应用价值。方法：回顾性分析9例艾滋病合并肝癌患者（研究组）及35例普通肝癌患者（对照组）的临床及影像资料，分析 TACE 术前、术后肝功能指标（ALT、TBIL）、细胞免疫指标及 AFP 值的变化情况，并采用 mRECIST 标准对肿瘤近期疗效进行评价。结果：研究组 TACE 术后1周肝功能指标（ALT、TBIL）较术前明显升高（P ＜0．05），术后1个月恢复至术前水平（P ＞0．05），与对照组变化一致；研究组 TACE 术后1个月 CD4＋、CD4＋／CD8＋水平与术前差异无统计学意义（P ＞0．05），与对照组变化一致；研究组 TA-CE 术后1个月肿瘤疗效与对照组差异无统计学意义（P ＞0．05）。结论：肝动脉化疗栓塞术对艾滋病合并肝癌患者是安全、有效的治疗方法。但由于艾滋病患者的特殊性，术前应根据患者机体免疫状况行高效抗逆转录疗法及抗微生物治疗预防真菌等机遇性感染，严格掌握 TACE 适应证，术中采用低于常规剂量的化疗药物。
목적：탐토간동맥화료전새술（TACE）재애자병합병간암환자중적응용개치。방법：회고성분석9례애자병합병간암환자（연구조）급35례보통간암환자（대조조）적림상급영상자료，분석 TACE 술전、술후간공능지표（ALT、TBIL）、세포면역지표급 AFP 치적변화정황，병채용 mRECIST 표준대종류근기료효진행평개。결과：연구조 TACE 술후1주간공능지표（ALT、TBIL）교술전명현승고（P ＜0．05），술후1개월회복지술전수평（P ＞0．05），여대조조변화일치；연구조 TACE 술후1개월 CD4＋、CD4＋／CD8＋수평여술전차이무통계학의의（P ＞0．05），여대조조변화일치；연구조 TA-CE 술후1개월종류료효여대조조차이무통계학의의（P ＞0．05）。결론：간동맥화료전새술대애자병합병간암환자시안전、유효적치료방법。단유우애자병환자적특수성，술전응근거환자궤체면역상황행고효항역전록요법급항미생물치료예방진균등궤우성감염，엄격장악 TACE 괄응증，술중채용저우상규제량적화료약물。
Objective:The purpose of this study was to investigate the clinical application value of transcatheter arteri-al chemoembolization (TACE)in treating primary liver cancer (PLC)in patients with AIDS.Methods:A total of 44 patients with PLC treated with TACE were divided into study group (n=9,AIDS)and control group (n=35,Non-AIDS).The liver function,T lymphocyte subsets and changes of AFP level of PLC patients were analyzed before and after the treatments. The therapeutic effectiveness was assessed by use of mRECIST within one month after the treatment,which was based on contrast CT or MR results.Results:In the study group,ALT and TBIL levels were increased in one week after TACE (P <0.05),and ALT and TBIL levels were decreased in one month after TACE (P >0.05).There was no significant difference in CD4+T lymphocyte and CD4+/CD8+ between the data before and one month after TACE (P >0.05).Also the results about therapeutic effectiveness showed no significant differences between study and control group (P >0.05).Conclusion:TACE can be a safe and effective procedure in treating primary liver cancer (PLC)in patients with AIDS.No significant differences were observed on the changes of liver function,cellular immunity indices and therapeutic effectiveness between the two groups according to our data.However,due to its particularity,the patients should be treated by highly active an-tiretroviral therapy (HARRT)and anti microorganism treatment to prevent opportunistic infections according to the pa-tients'immune status before TACE.The indications for TACE should be reviewed strictly before decisions are made,and the doses of chemotherapy during TACE procedures should be lower than regular ones.