医用三氧联合经导管肝动脉化疗栓塞对肝癌患者肝功能及细胞免疫功能的影响
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摘要
目的探讨医用三氧联合经导管肝动脉化疗栓塞(TACE)术治疗对肝癌患者肝功能及细胞免疫功能的影响。方法 62例肝癌患者,分为对照组及观察组,每组各31例,对照组行TACE术治疗,观察组行医用三氧联合TACE术治疗。分别于治疗开始前及术后10 d采血行单克隆抗体标记流式细胞仪检测CD_3、CD_4、CD8、自然杀伤细胞(NK)及肝功能检查[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]。结果与治疗前相比,观察组治疗后ALT、AST及TBIL降低,CD_3、CD_4、NK升高,CD_8下降,但差异均无统计学意义(P> 0.05);对照组治疗后ALT、AST及TBIL均显著升高,CD_3、CD_4、NK下降,CD_8升高,其中ALT、AST、TBIL、CD_4、CD_8、NK的变化差异具有统计学意义(P <0.05)。与对照组治疗后相比,观察组治疗后ALT、AST及TBIL均有下降;CD_3、CD_4、NK升高,CD_8下降,其中ALT、AST、CD_3、CD_4、CD_8的差异具有统计学意义(P <0.05)。结论医用三氧联合TACE术治疗可显著降低患者肝功能损伤的风险,增强术后细胞免疫功能。
Objective To probe the influence of medical O_3 combined with transcatheter arterial chemoem-bolization(TACE)on liver biochemical and cellular immune function in patients with hepatocellular carcinoma.Methods Sixty-two patients with primary liver cancer were randomly divided into control group(31 cases with therapy of TACE alone)and observation group(31 cases treated with medical O_3 combined with TACE). Before and 10 days after treatment,we used monoclonal antibody marker flow-cytometry to detect the cytokines(CD_3,CD_4,CD_8,NK)and liver function(ALT,AST,TBIL)in all patients. Results Compared with prior treatment,ALT,AST and TBIL levels reduced in the observation group after treatment,while CD_3,CD_4,NK levels elevated and CD_8 decreased. But the differences were not statistically significant(P > 0.05). Post treatment in the control group,ALT,AST and TBIL levels were significantly increased,while CD_3,CD_4 and NK levels were decreased but CD_8 increased. The differences of ALT,AST,TBIL,CD_4,CD_8 and NK were statistically significant respec-tively(P < 0.05). Moreover,the levels of ALT,AST,TBIL and CD8 decreased and CD_3,CD_4 and NK increased in the observation group post treatment compared with those of the control group. The differences of ALT,AST,CD_3,CD_4 and CD_8 levels between the two groups were statistically significant(P < 0.05). Conclusion The com-bination of medical O_3 and TACE can significantly reduce the risk of liver function injury and enhance the postoperative cellular immune function.
Objective To probe the influence of medical O_3 combined with transcatheter arterial chemoem-bolization(TACE)on liver biochemical and cellular immune function in patients with hepatocellular carcinoma.Methods Sixty-two patients with primary liver cancer were randomly divided into control group(31 cases with therapy of TACE alone)and observation group(31 cases treated with medical O_3 combined with TACE). Before and 10 days after treatment,we used monoclonal antibody marker flow-cytometry to detect the cytokines(CD_3,CD_4,CD_8,NK)and liver function(ALT,AST,TBIL)in all patients. Results Compared with prior treatment,ALT,AST and TBIL levels reduced in the observation group after treatment,while CD_3,CD_4,NK levels elevated and CD_8 decreased. But the differences were not statistically significant(P > 0.05). Post treatment in the control group,ALT,AST and TBIL levels were significantly increased,while CD_3,CD_4 and NK levels were decreased but CD_8 increased. The differences of ALT,AST,TBIL,CD_4,CD_8 and NK were statistically significant respec-tively(P < 0.05). Moreover,the levels of ALT,AST,TBIL and CD8 decreased and CD_3,CD_4 and NK increased in the observation group post treatment compared with those of the control group. The differences of ALT,AST,CD_3,CD_4 and CD_8 levels between the two groups were statistically significant(P < 0.05). Conclusion The com-bination of medical O_3 and TACE can significantly reduce the risk of liver function injury and enhance the postoperative cellular immune function.
引文
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[17]邓瑾,郑荣辉,黄赖机,等.三氧治疗对鼻咽癌放疗患者血清HIF-1α和VEGF水平的影响[J].现代医院,2012,12(1):23-25.
[18]郭志强,段惠萍.三氧治疗联合ECF方案治疗进展期胃癌的疗效观察[J].临床医药实践,2010,19(2A):113-115.
[19]BOCCI V,ZANARDI I,TRAVAGLI V.Oxygen/ozone as a medical gas mixture.A critical evaluation of the various methods clarifies positive and negative aspects[J].Gas Research,2011,1(6):1-9.
[20]BOCCI V,LAARINI A,MICHELI V.Restoration of normoxia by Ozone therapy may control neoplastic growth:A review and a working hypothesis[J].J Altem Complement Med,2005,11(2):257-265.
[21]SAGAI M,BOCCI V.Mechanisms of action involved in ozone therapy:Is healing induced via a mild oxidative stress[J].Medical Gas Research,2011,20(1):29-35.
[2]OTSUJI K,TAKAI K,NISHIGAKI Y,et al.Efficacy and safety of cisplatin versus miriplatin in transcatheterarterial chemoembolization and transarterial infusion chemotherapy for hepatocellularcarcinoma:A randomized controlled trial[J].Hepatol Res,2015,45(5):514-522.
[3]季峻松,陈婷,王辉,等.肝动脉化疗栓塞联合灌注三氧化二砷治疗原发性肝癌[J].实用医学杂志,2018,34(2):251-253.
[4]HATOOKA M,KAWAOKA T,AIKATA H,et al.Comparison of outcome of hepatic arterial infusion chemotherapy and sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization[J].Anticancer Res,2016,36(7):3523-3529.
[5]BRUIX J,REIG M,SHERMAN M.Evidence-based diagnosis,staging,and treatment of patients with hepatocellular carcinoma[J].Gastroenterology,2016,150(4):835-853.
[6]SPREAFICO C,CASCELLA T,FACCIORUSSO A,et al.Transarterial chemoembolization for hepatocellular carcinoma with a new generation of beads:Clinical-radiological outcomes and safety profile[J].Cardiovasc Intervent Radiol,2015,38(1):129-134.
[7]康海燕,董江龙,杨静,等.医用臭氧对聚乙二醇干扰素治疗慢性乙型肝炎疗效的影响[J].山东医药,2016,56(9):88-89.
[8]HYUN T K.Antioxidant,alpha-glucosidase inhibitory and antiinflammatory effects of aerial parts extract from Korean crowberry(Empetrum nigrum var.japonicum)[J].Saudi J Biol Sci,2016,23(2):181-188.
[9]SULLIVAN K M,GROESCHL R T,TURAGA K K,et al.Neutrophil-to-lymphocyte ratio as a predictor of outcomes for patients with hepatocellular carcinoma:a Western perspective[J].J Surg Oncol,2014,109(2):95-97.
[10]BAE S I,YEON J E,LEE J M,et al.A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma[J].Clin Mol Hepatol,2012,18(3):321-325.
[11]NOWAK R.Antioxidative and cytotoxic potential of some Chenopodium L.species growing in Poland[J].Saudi J Biol Sci,2016,23(1):15-23.
[12]刘庆,何晓峰.原发性肝癌介入术后序贯医用臭氧治疗的临床研究[D].广州:南方医科大学,2012.
[13]LIAO J,XIAO J,ZHOU Y,et al.Effect of transcatheter arterial chemoembolization on cellular immune function and regulatory Tcells in patients with hepatocellular carcinoma[J].Mol Med Rep,2015,12(4):6065-6071.
[14]ZHANG P,LU X,TAO K,et al.Siglec-10 is associated with survival and natural killer cell dysfunction in hepatocellular carcinoma[J].J Surg Res,2015,194(1):107-113.
[15]CHENG L S,LIU Y,JIANG W.Restoring homeostasis of CD4+T cells in hepatitis-B-virus-related liver fibrosis[J].World JGastroenterol,2015,21(38):10721-10731.
[16]LIU HR,LI W M.Treg-specific demethylated region activity in isolated regulatory T lymphocytes is a surrogate for disease severity in hepatocellular carcinoma[J].IUBMB Life,2015,67(5):355-360.
[17]邓瑾,郑荣辉,黄赖机,等.三氧治疗对鼻咽癌放疗患者血清HIF-1α和VEGF水平的影响[J].现代医院,2012,12(1):23-25.
[18]郭志强,段惠萍.三氧治疗联合ECF方案治疗进展期胃癌的疗效观察[J].临床医药实践,2010,19(2A):113-115.
[19]BOCCI V,ZANARDI I,TRAVAGLI V.Oxygen/ozone as a medical gas mixture.A critical evaluation of the various methods clarifies positive and negative aspects[J].Gas Research,2011,1(6):1-9.
[20]BOCCI V,LAARINI A,MICHELI V.Restoration of normoxia by Ozone therapy may control neoplastic growth:A review and a working hypothesis[J].J Altem Complement Med,2005,11(2):257-265.
[21]SAGAI M,BOCCI V.Mechanisms of action involved in ozone therapy:Is healing induced via a mild oxidative stress[J].Medical Gas Research,2011,20(1):29-35.