论著

CircRNA-0003340在2型糖尿病大鼠肝脏组织中的表达及意义

CircRNA-0003340 expression and significance in the liver of T2DM rats

:7-13
 
目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组(NC组,n=10)与2型糖尿病组(T2DM组,n=20),检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数(HOMA-IR);HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高(P<0.05),HDL-C降低(P<0.05)。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义(P<0.05)。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关(P<0.05)。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。
Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus (T2DM)rats and to explore its relationship with diabetes.Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group(NC group,n=10)and T2DM group(n=20),and fasting plasma glucose(FPG),fasting insulins(FINS),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT)levels were detected.Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index(HOMA-IR),HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR.Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C(P<0.05)and decreased HDL-C(P<0.05).The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference(P<0.05).Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC(P<0.05).Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM.
论著

无乳链球菌感染性心内膜炎并急性肝衰竭1例

Streptococcus agalactiae infective endocarditis with acute liver failure

:52-55
 
目的 探讨无乳链球菌感染性心内膜炎的临床特点和治疗效果。方法 回顾性分析我院收治的1例无乳链球菌感染性心内膜炎合并急性肝衰竭患者的临床表现、诊疗经过及预后。结果 经过积极抗感染、血浆置换和体外循环下赘生物清除、瓣膜置换手术治疗,术后继续予抗感染、抗凝等治疗,患者脏器功能恢复良好,取得了良好的治疗效果,并顺利出院。结论 无乳链球菌感染性心内膜炎可引起急性心力衰竭、急性肝衰竭、急性肾衰竭等多脏器功能不全,合理把握手术时机和准确评估围术期风险有助于提高急危重症感染性心内膜炎患者的救治率。
Objective To explore the clinical characteristics and treatment of infective endocarditis caused by Streptococcus agalactiae.Methods Clinical data and treatment details of a patient with Streptococcus agalactiae endocarditis and acute liver failure admitted to our hospital was analyzed retrospectively.Results After strict anti-biotic therapy and plasmapheresis,the patient received the vegetative removal and valve replacement and finally successfully recovered.Conclusions The diagnosis and treatment of this case suggests that Streptococcus agalactiae infective endocarditis can cause multiple organ dysfunction such as acute heart,liver and renal failure.Optimal timing of surgery and accurate benefits-risk assessment is helpful to improve the prognosis of patients with acute and severe infective endocarditis.
论著

MLR联合FT3对HBV相关慢加急性肝衰竭患者生存状况的预测效果

The predictive effect of MLR combined with FT3 on the survival of patients with chronic hepatitis B virus associated acute-on-chronic liver failure

:36-41
 
目的 分析单核细胞-淋巴细胞比率(MLR)联合游离三碘甲腺原氨酸(FT3)对乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者生存状况的预测效果。方法 纳入我院在2019年1月—2022年1月期间收治的HBV-ACLF患者共187例进行研究,随访患者90 d的生存状况,其中69例死亡患者设为死亡组,其余118存活患者设为存活组。对2组患者的各项资料进行单因素分析,对差异有统计学意义的因素行Logistic多因素分析,分析HBV-ACLF患者死亡的危险因素,并分析MLR联合FT3对HBV-ACLF死亡的预测效果。结果 死亡组患者的年龄、肝硬化发生率、原发性腹膜炎发生率、肝肾综合征发生率、电解质紊乱发生率、终末期肝病模型、MLR、中性粒细胞与淋巴细胞计数比值、国际标准化比值、肌酐、白细胞计数、总胆红素水平均高于B组,血钠、FT3、总血清胆固醇水平均低于存活组,差异有统计学意义(P<0.05)。MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05)。MLR、FT3、MLR+FT3对HBV-ACLF患者死亡均有一定的预测价值,但MLR+FT3的预测价值高于其他单项预测。结论 MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05),且二者联合应用对HBV-ACLF患者死亡有较佳的预测价值。
Objective To analyze the predictive effect of mononuclear-lymphocyte ratio(MLR)combined with free triiodothyronine(FT3)on the survival of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods In the study,187 patients with HBV-ACLF from January 2019 to January 2022 in our hospital were included,and the survival status of the patients was followed up for 90 days.Among them,69 patients were included in the death group and the rest 118 patients were included in the survival group.The data of the two groups of patients were analyzed by univariate analysis,and the statistically significant factors were analyzed by Logistic multifactor analysis.The risk factors of death in patients with HBV-ACLF were analyzed,and the predictive effect of MLR combined with FT3 on the death of HBV-ACLF was analyzed.Results The age,incidence of cirrhosis,primary peritonitis,hepatorenal syndrome,electrolyte disturbance,ratio of neutrophil to lymphocyte count,international standardized ratio,model for end stage liver disease,MLR,creatinine,white blood cell count and total bilirubin of the patients in the death group were higher than those in survival group,and the levels of serum sodium,FT3 and total cholesterol were lower than those in survival group,the differences were significant(P<0.05).The results showed that MLR≥0.60,FT3≤2.50 pmol/L were risk factors for death of HBV-ACLF patients(P<0.05).MLR,FT3,MLR+FT3 had certain predictive value for the death of HBV-ACLF patients,but the predictive value of MLR+FT3 was higher than other single prediction.Conclusions MLR≥0.60 and FT3≤2.50 pmol/L are risk factors for death of patients with HBV-ACLF(P<0.05),and the combination of the two has a better predictive value for death of patients with HBV-ACLF.
论著

CT扫描结合MRI在原发性肝癌诊断与介入治疗预后评估中的临床意义

Clinical significance of CT combined with MRI scans in diagnosis of primary liver cancer and prognosis evaluation after interventional therapy

:58-61
 
目的 分析CT+MRI在原发性肝癌诊断与介入治疗预后评估中的临床意义。方法 选定本院2019年1月—2021年1月住院治疗的150例原发性肝癌患者,入院后均接受介入治疗,分别予以CT、MRI检查,将手术病理检查结果作为本次研究的金标准,比较CT、MRI、CT+MRI诊断效能,Kappa检验CT、MRI、CT+MRI与金标准的一致性,比较CT、MRI、CT+MRI介入术后病灶检出率。结果 CT+MRI诊断准确率(98.67%)、特异度(75.00%)、灵敏度(99.32%)均高于CT(86.00%、25.00%、87.67%)、MRI(90.67%、91.78%、50.00%),P<0.05(差异均有统计学意义),CT+MRI与金标准的一致性较好(Kappa值为0.779),CT、MRI与金标准的一致性一般(Kappa值为0.527、0.596)。CT+MRI介入术后病灶总检出率(12.00%)高于CT(2.00%)、MRI(4.00%),P<0.05(差异有统计学意义)。结论 CT+MRI可提高原发性肝癌患者介入术后病灶检出率,弥补了单一CT、MRI检查的不足。
Objective To evaluate the clinical significance of CT + MRI scans in diagnosis of primary liver cancer and prognosis evaluation after interventional therapy. Methods A total of 150 cases of patients with primary liver cancer admitted to our hospital from January 2019 to January 2021 were selected. They all received interventional treatment, and were examined by CT and MRI. The results of pathological examination were taken as the gold standard in this study to compare the diagnostic efficacy of CT, MRI and CT+MRI.Kappa value was used to compare the consistency of CT, MRI, CT+MRI scans with gold standard, and compared the detection rate of lesions after CT, MRI and CT+MRI interventional surgery. Results The diagnostic accuracy (98.67%), specificity (75.00%) and sensitivity (99.32%) of CT + MRI scans were higher than those of CT (86.00%, 25.00%, 87.67%) and MRI scans (90.67%, 91.78%, 50.00%),P<0.05 (which differences were statistically significant). The consistency of CT + MRI scans with gold standard was good (kappa value was 0.779), but the consistency of CT/MRI scans with gold standard were not satisfying (kappa value were 0.527, 0.596). The total detection rate of lesions after CT + MRI interventional surgery (12.00%) was higher than that of CT (2.00%) and MRI (4.00%, which P<0.05). Conclusion CT + MRI scans can improve the detection rate of lesions in patients with primary liver cancer after interventional therapy, and make up for the deficiency of only CT or MRI scans.
论著

微泡超声空化在增强微波消融对肝脏肿瘤的热消融效应中的价值

Valuable study of microbubble ultrasound cavitation enhanced microwave ablation for liver cancer

:43-48
 
目的 通过研究微泡超声空化增强微波消融对兔VX2肿瘤的热消融效应来探究其在肿瘤治疗中的价值。方法 24只肝脏移植瘤兔随机分为空白对照组、单纯超声空化治疗组、单纯微波消融治疗组、超声空化联合微波消融治疗组4组。利用增强超声显示每组治疗前后肿瘤的大小、形状和轮廓并通过温度针来检测治疗区域的局部温度。结果 联合治疗组血流灌注缺损最严重,微波消融组和联合治疗组缺损体积分别为1.53±0.20和1.68±0.43(P=0.117);微波消融组以及联合治疗组消融治疗时温度达平台时间分别为(21.7±5.0)s和(10.3±5.0)s(P<0.01),最高温度(℃)分别为100.9±5.0和134.1±6.0(P<0.01)。结论 MWA联合MEUS治疗肝癌可使治疗区局部温度急剧升高至峰值温度,有望提高肝癌治疗效果。
Objective To investigate the thermal ablation effect of microbubble ultrasound cavitation combined with microwave ablation on rabbit VX2 tumors. Methods Twenty-four rabbits with liver transplantation tumors were randomly divided into four groups: blank control group, ultrasound-only cavitation treatment group, microwave-only ablation treatment group, and ultrasound-cavitation combined with microwave ablation treatment group. Enhanced ultrasound was used to show the size, shape and contour of the tumor before and after treatment in each group, and the local temperature of the treatment area was detected by a temperature needle. Results The blood flow perfusion defect was the most severe in the combined treatment group. The defect volume of the microwave ablation group and the combined treatment group were 1.53±0.20 and 1.68±0.43 (P=0.117). The temperature reached the plateau time in the microwave ablation group and the combined treatment group. It was (21.7±5.0)s and (10.3±5.0)s (P<0.01), and the highest temperature (℃) was 100.9±5.0 and 134.1±6.0 (P<0.01). Conclusion MWA combined with MEUS for liver cancer can sharply increase the local temperature in the treatment area to the peak temperature, which is expected to improve the treatment effect of liver cancer.
论著

香芹酚的解酒护肝作用的研究

Stdudy on the antialcoholism and liver protecting effects of carvacrol

:18-21
 
目的 观察香芹酚的解酒护肝作用。方法 将实验小鼠随机分为实验组(低剂量香芹酚组,中剂量香芹酚组,高剂量香芹酚组),生理盐水对照组和阳性对照组,观察小鼠行为学,醉酒小鼠的醉酒时间和醉酒潜伏期,检测血液中的乙醇浓度和肝组织中的SOD和MDA,计算肝比重。结果 与实验组比较,低,中,高剂量组香芹酚分别能显著延长小鼠的醉酒潜伏期(P<0.05),同时,各剂量的香芹酚组均可使肝组织中丙二醛(MDA)含量降低(P<0.05),肝组织中超氧化物歧化酶(SOD)活性分别增加(P<0.05)。结论 香芹酚具有解酒护肝作用,其作用机理可能与抗氧化活性有关。
Objective To observe the effect of carvacrol on MDA and SOD in acute alcoholic liver injury. Methods The experimental mice were randomly divided into the experimental group (low-dose carvacrol group, medium-dose carvacrol group, high-dose carvacrol group), normal saline control group and positive control group. The behavior of the mice was observed, the time and incubation period of drunkenness of the mice were observed, the concentration of alcohol in blood and SOD and MDA in liver tissues were detected, and the specific gravity of the liver was calculated. Results Compared with the experimental group, carvacrol in the low, medium and high dose groups could prolong the intoxication incubation period of mice (P<0.05), meanwhile, the content of malonaldehyde (MDA) in liver tissues was reduced in the carvacrol group (P<0.05), and the activity of superoxide dismutase (SOD) in liver tissues was increased in the carvacrol group (P<0.05). Conclusion Carvacrol has antialcoholism and liver protecting effects, and its mechanism may be related to antioxidant activity.
论著

逆转素对胆管结扎诱导大鼠肝损害的影响

Effect of reversine on liver damage induced by bile duct ligation in rats

:9-17
 
目的 探究小分子化合物逆转素(reversine,Rev)对胆管结扎(BDL)诱导的大鼠胆汁淤积性肝损害、纤维化、上皮细胞-间充质转化以及胆管反应的影响。方法 雄性Lewis大鼠随机分成三组,每组各5只。按照如下处理:BDL组大鼠行2周的胆管结扎;BDL+Rev组行胆管结扎同时给予腹腔注射逆转素;对照采用假手术(Sham)。2周后获取血液和肝组织。血指标检测总白蛋白(TP)、总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)。H&E染色检测肝组织病理。Azan染色检测组织胶原蛋白。免疫组化检测肝组织α平滑肌肌动蛋白(α-SMA)、结蛋白(Desmin)、波形蛋白(Vimentin)、细胞角蛋白(CK7,CK19)、β-连环蛋白(β-Catenin)以及上皮细胞粘附分子(EpCAM)蛋白的表达情况。结果 胆管结扎导致肝脏合成的总白蛋白量下降,总胆红素(TBIL)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)水平明显上升,逆转素处理使下降的总白蛋白上升,使上升的总胆红素(TBIL)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)水平向正常水平回复。逆转素可以缓解胆汁淤积引起的肝纤维化,表现为下调BDL引起的胶原蛋白和α-SMA蛋白沉积。逆转素可以抑制胆汁淤积引起的上皮细胞-间充质转化表现为逆转素明显降低BDL导致的Desmin和Vimentin的表达。逆转素可以抑制胆汁淤积引起的胆管反应表现为明显减少CK7和CK19阳性胆管的表达含量。逆转素抑制胆汁淤积引起的胆管反应与调节β-Catenin和EpCAM的表达有关。结论 逆转素可以缓解胆汁淤积引起的大鼠肝损害,具有一定的保护作用。逆转素可以成为一种潜在治疗药物。
Objective To investigate the effect of reversine (REV) on bile duct ligation (BDL) -induced hepatic damage, fibrosis, epithelial-mesenchymal transformation, and ductular reaction in rats. Methods Male Lewis rats were randomly divided into three groups with 5 rats in each group. Bile duct ligation was performed in the BDL group for two weeks. BDL+ REV group was treated with bile duct ligation and intraperitoneal injection of reversine. The control group was Sham operation (Sham). Blood and liver tissue were obtained after 2 weeks. Blood indexes were determined for total albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and γ-glutamyl transpeptidase. Hepatic histopathology was detected by H&E staining. Azan staining was used to detect tissue collagen deposition. Immunohistochemistry was used to detect the expression of α-SMA, desmin, vimentin, cytokeratin, β-catenin and epithelial cell adhesion molecule (EpCAM) protein. Results Bile duct ligation resulted in the decrease of total albumin synthesis in liver, and the increase of total bilirubin, glutamic-oxalacetic transaminase, alkaline phosphatase and γ-glutamyltranspeptidase. The levels of total bilirubin, aspartate transaminase, alkaline phosphatase and γ-glutamyltranspeptidase returned to the normal level with reversine treatment. Reversine could alleviate cholestasis-induced liver fibrosis by downregulating BDL-induced deposition of collagen and α-SMA protein. Reversine inhibited cholestasis-induced epithelial-mesenchymal transformation by significantly reducing BDL-induced desmin and vimentin expression. Reversine could inhibit cholestasis-induced ductular reaction by significantly reducing the expression of CK7 and CK19 positive biliary cells. Inhibition of cholestasis induced ductular reaction by reversine was associated with regulation of β-catenin and EpCAM expression. Conclusion Reversine can alleviate liver damage caused by cholestasis in rats and have a protective effect. Reversine may be a potential treatment that need further investigation.
论著

71例肝脓肿临床及病原学特点分析

Clinical and bacteriological analysis of 71 cases with pyogenic liver abscess

:55-59
 
目的 分析肝脓肿的临床基线及病原学特征,旨在提高临床对该病早期识别、病原体预判、并发症警惕及抗感染治疗能力。方法 收集广州番禺区中心医院2019年1月—2020年11月收治的肝脓肿病例相关临床及实验室资料。按病原体培养结果分成阳性组、阴性组。阳性组中,按不同致病菌分成肺炎克雷伯及非肺炎克雷伯亚组。比较不同组别间基线特征及实验室数据。结果 共收集肝脓肿71例,病原学培养阳性率83.1%(59例),其中肺炎克雷伯菌46例(80%)。最常见合并症包括糖尿病(54.9%)、胆道疾病(56.3%)、肺部感染(67.6%)等。病原体阳性组PCT和AST水平高于阴性组(P<0.05),但是两组之间基线特征无差异(P>0.05)。肺炎克雷伯亚组与其他病原体组相比,合并糖尿病的风险更高(P=0.007),PLT、PCT、ALT、AST和白蛋白的水平具有显著差异(P <0.05)。经过积极治疗,大多预后良好,未见死亡病例,其中7例患者发生严重侵袭性脓肿,遗留后遗症。结论 病原体阴性肝脓肿致病力方面与阳性组并无差别。肺炎克雷伯杆菌已成为肝脓肿中最常见菌群,其多见于合并糖尿病患者。其PLT、PCT、ALT、AST指标明显高于其他菌群组,伴白蛋白消耗明显。少数可伴有全身严重侵袭性脓肿。
Objective To investigate the clinical and etiological characteristics of pyogenic liver abscess (PLA) as a reference for its early identification,early prediction of pathogens, alertness to complications and rational antibacterial treatment. Methods A single center retrospective study was carried out in patients with PLA in Guangzhou Panyu Center Hospital from January 2019 to November 2020.The clinical and laboratory data of all liver abscess cases were concluded. Baseline characteristic and laboratory outcomes were grouped into Klebsiella pneumoniae group and non-Klebsiella pneumoniae subgroup according to different pathogenic bacteria. Results Among a total of 71 patients with liver abscess, 83.1%(n=59)had positive cultures. Klebsiella pneumoniae accounted for the most in 46 cases (80.0%). The most common complications included diabetes(50.7%), biliary tract disease(56.3%), pulmonary infection(67.6%) etc. The levels of PCT and AST in pathogen culture-positive group were higher than those in culture-negative group, with statistical significance (P<0.05),on the contrary there were no differences in baseline characteristic among the groups according to the results of pathogens. Compared with other pathogens, the group of Klebsiella pneumoniae liver abscess presented higher risk of diabetes.The levels of PLT, PCT, ALT, AST,and albumin in the two groups were different (P<0.05). Most patients had good outcomes, while 7 patients had residual problems represented with severe invasive abscess. Conclusion There were similar consequences between negative and positive liver abscesses. Klebsiella pneumoniae has become the most common bacteria in liver abscess. Among which, PLT、PCT、ALT、AST indexes are higher than that of other bacteria with obvious albumin depletion, even some of which may be accompanied by systemic severe invasive abscess.
论著

原发性肝癌患者循环肿瘤细胞检测及其与术后复发转移的关系

Detection of circulating tumor cells in patients with primary liver cancer and its relationship with postoperative recurrence and metastasis

:36-39
 
目的 检测外周血循环肿瘤细胞(circulating tumor cell, CTC)在原发性肝癌患者中的表达情况,并探讨CTC动态变化及其相对于甲胎蛋白(Alpha fetoprotein AFP)对原发性癌患者术后复发转移的预测作用。方法 收集原发性肝癌患者134例,肝脏良性病变患者72例,检测外周血 CTC 数目,同时检测AFP的表达水平,分析 CTC 与 AFP 的相关性。然后在134名原发性肝癌患者中筛选出成功行肝癌根治术的患者,共86例,检测这86名患者术前、术后外周血CTC和AFP,分析CTC和AFP对原发性肝癌术后复发转移的评估价值。结果 原发性肝癌患者外周血CTC阳性率高于肝脏良性病变患者,差异有统计学意义(P<0.05);原发性肝癌患者CTC水平与AFP水平、淋巴结转移、肿瘤结节多少有关,与年龄、性别、肿瘤直径、分化程度、肝硬化有无、TNM分期无关;原发性肝癌患者CTC和AFP生存分析显示,原发性肝癌根治术后早期复发转移与CTC和AFP密切相关;CTC较阳性对术后复发转移具有更好的诊断价值,二者联合对复发转移预测价值最高。结论 CTC可以做为一个比传统肿瘤标志物更好的对原发性肝癌术后复发转移进行监测的指标,与肿瘤标志物联合检测预测价值更高。
Objective To detect the expression of peripheral blood circulating tumor cells CTC in patients with primary liver cancer and to explore the dynamic changes of CTC and its predictive effect on postoperative recurrence and metastasis of primary cancer. Methods The number of CTC in peripheral blood was measured in 134 patients with primary liver cancer and 72 patients with benign liver disease, the expression of AFP was detected, and the correlation between CTC and AFP was analyzed. Then 86 patients with primary liver cancer were selected from 134 patients with primary liver cancer who underwent radical hepatectomy. The values of CTC and AFP in evaluating recurrence and metastasis of primary liver cancer before and after operation were analyzed by CTC and AFP, in peripheral blood of these 86 patients. Results The positive rates of CTC in peripheral blood of patients with primary liver cancer were higher than that of patients with benign liver disease(P< 0.05). The levels of CTC in patients with primary liver cancer were related to AFP level, lymph node metastasis and the number of tumor nodules, but not to age, sex, tumor diameter, differentiation degree, liver cirrhosis and TNM stage. The survival analysis of CTC and AFP in patients with primary liver cancer showed that the early recurrence and metastasis of primary liver cancer after radical resection were closely related to the positive rate of CTC and AFP, and the positive rate of CTC was more effective than that of AFP positive in the diagnosis of recurrence and metastasis after operation, and the combination of the two had the highest predictive value for recurrence and metastasis. Conclusion CTC may be used as a better index to monitor postoperative recurrence and metastasis of primary liver cancer than traditional tumor markers. The combined detection prediction value of tumor markers is higher.
论著

贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌的 Meta分析

Efficacy of Bevacizumab combined with thanscatheter artierial chemoembolzation for treating primary liver cancer: Meta analysis

:86-92
 
目的 评价贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌的疗效及不良反应。方法 2名评价员通过独立地检索中英文数据库,纳入随机对照研究,其中治疗组为肝动脉灌注贝伐单抗联合肝动脉化疗栓塞组、对照组为单独肝动脉化疗栓塞组,并通过Jadad量表对纳入文献质量进行评分,最后采用Review Manager 5.2软件进行Meta分析。结果 纳入6篇文献,466例病例。结果显示:在疗效方面,治疗组的3、6个月疾病有效率及疾病控制率,12个月的生存率均高于对照组且差异有统计学意义(P<0.05);在安全性方面,两组间关于发热、转氨酶升高、恶心、黑便的发生率之间的比较无统计学意义(P>0.05)结论 肝动脉灌注贝伐单抗联合肝动脉化疗栓塞治疗原发性肝癌与单独肝动脉化疗栓塞比较,能有效提高肝癌患者近期及远期疗效,且并不增加不良反应发生率。
Objective To evaluate the efficacy and side effects of bevacizumab combined with thanscatheter artierial chemoembolzation in the treatment of primary liver cancer. Methods Two reviewers collected data about clinical trials that the combination of bevacizumab and thanscatheter artierial chemoembolzation for treatment of primary liver cancer from data bases. Jadad Score and Review Manager 5.2 software were respectively used to assess the quality of included studies and analyze the obtained data. Results Six randomized controlled trials involving 466 patients were included in this paper. The results of the meta-analysis showed that compared with thanscatheter artierial chemoembolzation group alone, bevacizumab combined with thanscatheter artierial chemoembolzation improved the response rate and disease control rate, prolonged 12 month survival rate (P<0.05). As for side effects, there were no statistically different of those about fever, level of transaminase, nausea and melena between two groups(P>0.05). Conclusion Compared with simple thanscatheter artierial chemoembolzation group, and Bevacizumab combined with thanscatheter artierial chemoembolzation group, the later may improve short-term and long-term effects, and side effects were under control.
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