目的 分析信迪利单抗联合索拉非尼对晚期肝癌患者的疗效及对血清甲胎蛋白(alpha fetoprotein,AFP)和异常凝血酶原(protein induced by vitamin K absence or antagonist Ⅱ,PIVKA-Ⅱ)的影响.方法 选取 2019年4月至 2020年6月于本院就诊的晚期肝癌患者88例,按随机数字表法分组,对照组给予常规治疗加用索拉非尼,联合组在对照组基础上加用信迪利单抗,每组44例.比较两组的疾病控制率、肝功能指标、AFP以及PIVKA-Ⅱ水平,观察患者的不良反应及中位生存期情况.结果 联合组疾病控制率较对照组高(90.91％vs 72.73％,x2=4.889,P=0.027).两组丙氨酸转氨酶、总胆红素、AFP以及PIVKA-Ⅱ水平较治疗前降低,白蛋白较治疗前升高,且联合组优于对照组,差异有统计学意义(P＜0.05).联合组中位生存时间长于对照组,差异有统计学意义(t=8.095,P＜0.001).联合组2年生存率(17/44,38.64％)较对照组(8/44,18.18％)高(x2=5.320,P=0.021).结论 信迪利单抗联合索拉非尼治疗晚期肝癌的效果较佳,可有效改善肝功能,具有一定安全性,值得临床推广应用.
Efficacy of sintilimab combined with sorafenib in the treatment of advanced liver cancer
Objective To investigate the efficacy of sintilimab combined with sorafenib in the treatment of advanced liver cancer and its influence on serum alpha fetoprotein(AFP)and protein induced by vitamin K absence or antagonistⅡ(PIVKA-Ⅱ).Methods A total of 88 patients with advanced liver cancer treated in our hospital from April 2019 to June 2020 were selected and divided into control group and combined group according to random number table method.The control group given conventional treatment combined with sorafenib,and the combined group was given sintilimab on the basis of the control group,with 44 cases in each group.The disease control rates,liver function index,AFP and PIVKA-Ⅱlevels were compared between the two groups.The adverse reactions of patients and the median survival situation were observed.Results After treatment,the disease control rate of the combined group was higher than that of the control group(90.91％vs 72.73％,x2=4.889,P=0.027).The levels of alanine aminotransferase,total bilirubin,AFP and PIVKA-Ⅱin both groups were lower than before treatment,and albumin was higher than before treatment,and the combined group was better than the control group,and the difference was statistically significant(P＜0.05).The median survival time of the combined group was longer than that of the control group,and the difference was statistically significant(t=8.095,P＜0.001).The 2-year survival rate in the combined group(17/44,38.64％)was higher than that in the control group(8/44,18.18％,x2=5.320,P=0.021).Conclusion Sintilimab combined with sorafenib has good efficacy in the treatment of advanced liver cancer,can effectively improve the liver function of patients,and has a certain safety,worthy of clinical promotion and application.
sintilimabsorafenibadvanced liver canceralpha fetoproteinprotein induced by vitamin K absence or antagonist Ⅱ
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