門冬氨酸鳥氨酸對原發性肝癌放療患者血管內皮生長因子的影響

楊光輝 薛濤 馬博 李萍 俞雪梅 莫建民 許麗萍

[摘要] 目的 評價門冬氨酸鳥氨酸治療原發性肝癌放射性肝損傷的效果，并觀察門冬氨酸鳥氨酸對原發性肝癌放療患者血清血管內皮生長因子（VEGF）水平的影響。 方法 選取湖州師范學院附屬第一醫院2011年9月～2013年12月收治的肝癌患者120例，分為對照組及觀察組，每組各60例。對照組患者在放療時接受保肝、保胃和止血處理，觀察組則在對照組的基礎上聯合使用門冬氨酸鳥氨酸。對兩組患者的肝功能改變情況進行生化檢測，以判定療效。并采用酶聯免疫吸附法（ELISA）對血清中VEGF濃度進行檢測。 結果 兩組患者都順利的完成了放療，臨床癥狀得到了明顯的改善。觀察組明顯改善率[46.67%（28/60）]高于對照組明顯改善率[26.67%（16/60）]，差異有統計學意義（P < 0.05）。觀察組患者治療后14 d肝功能各項觀察指標均明顯高于治療前，處于正常范圍，差異有統計學意義（P < 0.05）。治療后，觀察組VEGF水平[（173.2±35.8）pg/mL]低于對照組VEGF水平[（267.5±37.1）pg/mL]，差異有高度統計學意義（P < 0.01）。 結論 門冬氨酸鳥氨酸在治療肝癌放射性肝損傷方面具有一定優勢，能夠促進膽紅素代謝，減少肝細胞損傷，有效保護肝臟，并能顯著改善原發性肝癌放療患者血清VEGF水平。

[關鍵詞] 原發性肝癌；門冬氨酸鳥氨酸；放射性肝損傷；血清；血管內皮生長因子

[中圖分類號] R285.6，R735.7[文獻標識碼] A[文章編號] 1673-7210（2014）05（c）-0065-04

Effect of Ornithine Aspartate intervention on vascular endothelial growth factor of patients with primary hepatic carcinoma radiotherapy

YANG Guanghui XUE Tao▲ MA Bo LI Ping YU Xuemei MO Jianmin XU Liping

Department of Pharmacy, the First Affiliated Hospital of Huzhou Teachers College, Zhejiang Province, Huzhou 313000, China

[Abstract] Objective To evaluate the efficacy of Ornithine Aspartate in the treatment of primary hepatic carcinoma radiation-induced liver injury. And to observe the influence of Ornithine Aspartate on serum vascularendothelial growth factor (VEGF) level in patients of primary hepatic carcinoma with radiotherapy. Methods 120 cases of liver cancer patients in the First Affiliated Hospital of Huzhou Teachers College from September 2011 to December 2013 were selected and divided into control group and observation group, with 60 cases in each group. The patients in control group were treated with liver, stomach and hemostatic treatment in the radiotherapy. The observation group was treated with Ornithine Aspartate on the basis of the control group method. The change of liver biochemical function was tested to determine the curative effect. The serum concentration of VEGF was detected using the enzyme-linked immunosorbent assay (ELISA). Results Patients of two groups were successfully completed the treatment, the clinical symptoms improved obviously. Significant improvement rate of the observation group was [46.67% (28/60)] was more than that of the control group [26.67% (16/60)], the difference was statistically significant (P < 0.05). 14 d after treatment, liver function indexes of patients in the observation group were significantly higher than that before treatment, all in the normal range, the differences were statistically significant (P < 0.05). After treatment, the level of VEGF in the observation group [(173.2±35.8) pg/mL] was lower than that of the control group [(267.5±37.1) pg/mL], the difference was statistically significant (P < 0.01). Conclusion Ornithine Aspartate has certain advantages in the treatment of radiation-induced liver injury liver, it can promote the metabolism of bilirubin, reduce liver cell damage, protect the liver, and can significantly improve the level of serum VEGF in patients with primary hepatic carcinoma about radiotherapy.

[Key words] Primary liver cancer; Ornithine Aspartate; Radiation induced liver injury; Serum; Vascular endothelial growth factor

原發性肝癌（簡稱肝癌）是一種較為常見的惡性腫瘤，最常用的治療手段是手術療法，但是滿足手術要求的患者比例很低[1]，所以很多患者只能采用非手術治療。其中，放療是非手術治療的主要手段之一。近幾年，計算機技術得到了迅猛的發展，放療最新技術也隨之而發展，其中三維適形放療（3DCRT）的產生和發展比較值得關注，該治療方式給腫瘤極高的放射劑量，而降低了對健康組織的劑量，有效提升了腫瘤局部控制率，降低了放射并發癥的發病率[2]。然而患者在接受肝動脈結扎、化療、放療等治療方式時會加重對肝功能的損傷[3]，更有甚者會出現肝功能衰竭。……