地塞米松小剂量辅助TACE在原发性肝癌治疗中的抗炎与肝功能保护作用研究

doi:10.3969/j.issn.1006-6233.2025.04.015

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摘要 目的: 探讨地塞米松小剂量辅助肝动脉化疗栓塞术(TACE)在原发性肝癌(PLC)治疗中的抗炎与肝功能保护作用。方法: 选取2020年1月至2024年9月期间在我院诊治的256例PLC患者,采取区组随机法分为对照组(n=128,TACE治疗)和研究组(n=128,地塞米松小剂量辅助TACE治疗),比较两组炎症因子、肝功能、肿瘤标志物和疗效。结果: 和术前相比,两组术后7d的肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)、白细胞介素(IL)-6升高(P<0.05),两组术后7d的IL-2降低(P<0.05),但和对照组相比,研究组TNF-α、CRP、IL-2、IL-6手术前后差值更低(P<0.05)。和术前相比,两组术后7d的直接胆红素(DBIL)、总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)升高(P<0.05),但和对照组相比,研究组DBIL、TBIL、AST、ALT手术前后差值更低(P<0.05)。和术前相比,两组术后7d的甲胎蛋白(AFP)、细胞角蛋白19(CK19)降低(P<0.05),但和对照组相比,研究组AFP、CK19手术前后差值更高(P<0.05)。研究组客观缓解率(DRR)、疾病控制率(DCR)分别为75.00%、88.28%,和对照组的62.50%、70.31%相比更高(P<0.05)。结论: 地塞米松小剂量辅助TACE在PLC治疗中,抗炎作用和肝功能保护作用显著,且可降低肿瘤标志物水平,提高治疗疗效。

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关键词 ：原发性肝癌, 肝动脉化疗栓塞术, 地塞米松, 肝功能

Abstract：Objective: To explore the anti-inflammatory and liver function protective effects of low-dose dexamethasone-assisted hepatic artery chemoembolization (TACE) in the treatment of primary liver cancer (PLC). Methods: A total of 256 patients with PLC treated in our hospital from January 2020 to September 2024 were randomly divided into a control group (n=128, TACE treatment) and a study group (n=128, low-dose dexamethasone assisted TACE treatment) using a block randomization method. The inflammatory factors, liver function, tumor markers, and efficacy of the two groups were compared. Results: Compared with preoperative levels, the postoperative levels of tumor necrosis factor (TNF) - α, C-reactive protein (CRP), and interleukin-6 (IL-6) increased in both groups 7days after surgery (P<0.05), and the levels of IL-2 decreased in both groups 7days after surgery (P<0.05). Compared with the control group, the study group had lower differences in TNF - α, CRP, IL-2, and IL-6 before and after surgery (P<0.05). Compared with preoperative levels, the postoperative levels of direct bilirubin (DBIL), total bilirubin (TBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) increased in both groups 7days after surgery (P<0.05). Compared with the control group, the study group had lower differences in DBIL, TBIL, AST, and ALT before and after surgery (P<0.05). Compared with preoperative levels, the postoperative levels of alpha fetoprotein (AFP) and cytokeratin 19 (CK19) in both groups decreased at 7 days after surgery (P<0.05). Compared with the control group, the study group had higher differences in AFP and CK19 before and after surgery (P<0.05). The objective response rate (DRR) and disease control rate (DCR) of the research group were 75.00% and 88.28%, respectively, which were higher than the control group's 62.50% and 70.31% (P<0.05). Conclusion: Dexamethasone low-dose adjuvant TACE has significant anti-inflammatory and liver function protective effects in PLC treatment, and can reduce tumor marker levels, improving treatment efficacy.

Key words： Primary liver cancer Hepatic artery chemoembolization Dexamethasone Liver function

基金资助:河北省医学科学研究课题,(编号:20210827)

通讯作者: 贾志强

引用本文:

马立伟, 贾志强, 陈午盛, 刘琼, 段玉松. 地塞米松小剂量辅助TACE在原发性肝癌治疗中的抗炎与肝功能保护作用研究[J]. 河北医学, 2025, 31(4): 619-625.
MA Liwei, JIA Zhiqiang, CHEN Wusheng, et al. Study on the Anti-Inflammatory and Liver Function Protective Effects of Low-Dose Dexamethasone Assisted TACE in the Treatment of Primary Liver Cancer. HeBei Med, 2025, 31(4): 619-625.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.04.015 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I4/619

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