CAJ | 학술논문

目的：分析重组人血管内皮抑制素注射液联合经肝动脉化疗栓塞（TACE）治疗肝癌的临床疗效及安全性。方法选取2011年6月至2013年6月原发性肝癌患者共80例，随机分为实验组和对照组。对照组予以 TACE 治疗，实验组予以重组人血管内皮抑制素注射液加 TACE 治疗。对比两组患者治疗前后的血管内皮生长因子（VEGF）、基质金属蛋白酶（MMP）、乏氧诱导因子- lα（HIF -1α）、骨桥蛋白（OPN）和结缔组织生长因子（CTGF）水平。对比两组患者治疗后的不良反应发生率、临床疗效和预后生存情况。结果术后7 d 实验组的 VEGF 和 MMP 水平均显著低于对照组（ P ﹤0.05）；术后28 d 实验组的 MMP 水平低于对照组（ P ﹤0.05）。两组患者术后7 d 的 OPN 和 CTGF 水平均显著高于术前7 d，而术后28 d 的 OPN 和 CTGF 水平均显著高于术后7 d；实验组术后7 d 的 OPN 和 CTGF 水平均显著低于对照组，术后28 d 的 OPN 和 CTGF 水平均显著低于对照组（ P ﹤0.05）。两组各时间点 HIF -1α水平差异均无显著性（ P ﹥0.05）。两组患者治疗后的不良反应发生率无显著差异（ P ﹥0.05）。实验组的总有效率显著高于对照组（ P ﹤0.05）。实验组术后平均存活时间345 d，疾病进展时间272 d；对照组术后平均存活时间324 d，疾病进展时间235 d。结论重组人血管内皮抑制素注射液联合 TACE 治疗肝癌可有效抑制肿瘤生长，提高临床疗效和延长患者生存时间，同时不增加不良反应发生率，其作用机制可能与抑制 TACE 术后血浆 VEGF、MMP、OPN、CTGF 水平有关。
목적：분석중조인혈관내피억제소주사액연합경간동맥화료전새（TACE）치료간암적림상료효급안전성。방법선취2011년6월지2013년6월원발성간암환자공80례，수궤분위실험조화대조조。대조조여이 TACE 치료，실험조여이중조인혈관내피억제소주사액가 TACE 치료。대비량조환자치료전후적혈관내피생장인자（VEGF）、기질금속단백매（MMP）、핍양유도인자- lα（HIF -1α）、골교단백（OPN）화결체조직생장인자（CTGF）수평。대비량조환자치료후적불량반응발생솔、림상료효화예후생존정황。결과술후7 d 실험조적 VEGF 화 MMP 수평균현저저우대조조（ P ﹤0.05）；술후28 d 실험조적 MMP 수평저우대조조（ P ﹤0.05）。량조환자술후7 d 적 OPN 화 CTGF 수평균현저고우술전7 d，이술후28 d 적 OPN 화 CTGF 수평균현저고우술후7 d；실험조술후7 d 적 OPN 화 CTGF 수평균현저저우대조조，술후28 d 적 OPN 화 CTGF 수평균현저저우대조조（ P ﹤0.05）。량조각시간점 HIF -1α수평차이균무현저성（ P ﹥0.05）。량조환자치료후적불량반응발생솔무현저차이（ P ﹥0.05）。실험조적총유효솔현저고우대조조（ P ﹤0.05）。실험조술후평균존활시간345 d，질병진전시간272 d；대조조술후평균존활시간324 d，질병진전시간235 d。결론중조인혈관내피억제소주사액연합 TACE 치료간암가유효억제종류생장，제고림상료효화연장환자생존시간，동시불증가불량반응발생솔，기작용궤제가능여억제 TACE 술후혈장 VEGF、MMP、OPN、CTGF 수평유관。
Objective To analyze the clinical efficacy and safety on recombinant human endostatin injection combined TACE for liver cancer. Methods 80 cases of primary liver cancer June 2011 to June 2013 were randomly divided into experimental and control groups. The con-trol group received TACE treatment,the experimental group received recombinant human endostatin injection and TACE therapy. The vascular en-dothelial growth factor treatment(VEGF),matrix metalloproteinase(MMP),hypoxia - inducible factor - lα(HIF - 1α),osteopontin(OPN) and connective tissue growth factor(CTGF)levels in two groups of patients were compared before and after treatment. The incidence of adverse re-actions clinical efficacy and prognosis survival in two groups of patients were also compared. Results VEGF and MMP after seven days in the ex-perimental group was significantly lower than those of the control group( P ﹤ 0. 05). MMP levels after 28 days in the experimental group was sig-nificantly lower than that of the control group( P ﹤ 0. 05). OPN and CTGF after seven days in two groups of patients were significantly higher than 7 days before surgery,and OPN and CTGF after 28 days were significantly higher than those after 7 days. OPN and CTGF in the experimental group after seven days were significantly lower than those in the control group,OPN and CTGF after 28 days were significantly lower than those in the control group( P ﹤ 0. 05). Adverse reactions after two groups of patients had no significant difference( P ﹥ 0. 05). The total efficiency of the experimental group were significantly higher( P ﹤ 0. 05). The mean survival time of experimental group was 345 d,time to disease progression 272 d;mean survival time of control group was 324 d,time to disease progression 235 d. Conclusion Recombinant human endostatin injection combined TACE for liver cancer can effectively inhibit tumor growth,increase the clinical efficacy and patient survival time,without increasing the incidence of adverse reactions. The mechanism may be related to the inhibition of TACE plasma VEGF,MMP,OPN,CTGF levels.