动脉置管灌注华蟾素注射液联合TACE术对原发性肝癌患者HIF—1α、VEGF的影响及其机理探讨(1)

http://www.100md.com 2018年1月15日 《世界中医药》 20182

     摘要 目的：观察动脉置管灌注华蟾素注射液联合TACE术对原发性肝癌患者治疗后血清缺氧诱导因子-1α(HIF-1α)和血管内皮生长因子(VEGF)的影响，以探讨其作用机理。方法：选取2015年7月至2017年9月郑州市中医院肿瘤科、肝病科收治的原发性肝癌患者的90例，随机分成观察组45例(动脉置管灌注华蟾素注射液+TACE术组)和对照组45例(单纯TACE组)。检测2组患者术前1 d、术后1 d、术后1周及术后4周血清缺氧诱导因子-1α(HIF-1α)和血管内皮生长因子(VEGF)的水平，并观察2组的疾病控制率和肿瘤标志物AFP的变化。结果：观察组和对照组的HIF-1α、VEGF在TACE术后1 d和1周均较治疗前1 d明显升高(P<0.05)，在TACE术后4周恢复到术前水平。其中观察组术后1周的HIF-1α、VEGF低于对照组，差异有统计学意义(P<0.05)。观察组、对照组的疾病控制率分别为93.3%和75.6%，经比较，有统计学意义(P<0.05)。观察组AFP经治疗后明显下降，与对照组比较，差异有统计学意义(P<0.05)。结论：采用动脉置管持续灌注华蟾素注射液的方法，可提高TACE术治疗原发性肝癌的临床疗效，抑制HIF-1α和VEGF可能是其作用机理。
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    关键词 华蟾素注射液；原发性肝癌；缺氧诱导因子-1α；血管内皮生长因子

    Abstract Objective：To observe the effects and functional mechanism of arterial catheter infusion cinobufacini injection combined with transhepatic arterial chemotherapy and embolization (TACE) on HIF-1α and VEGF of patients with primary liver cancer.Methods：A total of 90 patients with primary liver cancer patients were admitted and treated in Oncology Department and Liver Disease Department of Zhengzhou Hospital of Traditional Chinese Medicine，and they were randomly divided into two groups，treatment group (arterial catheter infusion cinobufotain +TACE)，and control group(only TACE)，with 45 cases in each group.The changes of HIF-1α and VEGF levels were evaluated 1 day before operation，1 day after operation，1 week after operation and 4 weeks after operation in both groups.Besides，disease control rate and tumor marker (AFP) were also evaluated before and after treatment.Results：The levels of HIF-1α and VEGF 1 day and 1 week after TACE operation in treatment group and control group were significantly higher than those 1 day before treatment (P<0.05)，and recovered to the levels before operation after 4 weeks.Meanwhile，the levels of HIF-1α and VEGF 1 week after operation in the treatment group were lower than those in the control group，which had statistic significance (P<0.05).The disease control rate of treatment group (93.3%) was better than that in control group (75.6%) (P<0.05).There was statistically significant significance (P<0.05).The decrease of AFP in the treatment group was more significant than that in the control group (P<0.05).Conclusion：The method of arterial catheter infusion cinobufacini injection can increase the therapeutic effect of TACE on primary liver cancer and decrease the levels of HIF-1α and VEGF of patients，which was probably the mechanism of it.

    Key Words Cinobufotain injection； Primary liver cancer； HIF-1α； VEGF

    中圖分类号：R273；R242文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.02.037, 百拇医药(李佳 曾宝珠 孙志刚)

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