Effect Of Thymosin A1 On Early Cellular Immune Function And Liver Function In Patients With Hepatocellular Carcinoma After Hepatectomy

Objective:To study the effect of early use of thymosina1(TSa1)on cellular immunity and liver function in patients with primary hepatocellular carcinoma(HCC)after hepatectomy,and provide a theoretical basis for the rational application of TSa1 in clinical practice.Methods:Retrospective analysis of the perioperative clinical data of 665patients with HCC who underwent hepatectomy from April 1,2014 to December 30,2018.According to whether HCC patients were treated with TSa1within one week after surgery,the use was divided into four.Group:199patients in group A were not treated with TSa1 after operation;376 patients in group B were treated with TSa1 on the 1st and 4th day after operation;48patients in group C were treated with TSa1 on the 1st,3rd and 5th postoperatively;42 cases in group D were treated.Patients were treated with TSa1 for 1 week after surgery.The other treatments(such as liver protection,nutrition,etc.)were basically the same in the four groups.In order to better control the bias caused by clinicopathological factors that may affect cellular immunity during perioperative period,firstly,four groups of data were subjected to 1:n propensity score matching(PSM),and then four groups of peripheral venous blood lymphocytes were performed.Comparison of CD3~+,CD4~+,CD8~+,CD4~+/CD8~+,and liver function and postoperative complications between the four groups.Results:The inter-group effect showed that there was significant difference between the groups of CD3~+,CD4~+,ALT and AST(P<0.05),and there was no significant difference between the other groups(P>0.05).The results of multiple comparison between groups showed that the effect of CD3~+expression level in group A was lower than that in group D(P=0.002),and there was no significant difference in CD3~+expression level between the other groups(P>0.05);A,B,The effect of CD4~+expression level in group C was lower than that in group D(P=0.001,0.007,0.012).There was no significant difference in CD4~+expression between the other groups(P>0.05).Group A patients had high ALT and AST.In group D(P=0.003,0.040),there was no significant difference in ALT and AST between the other groups(P>0.05).There was no significant difference in the incidence of postoperative complications among the four groups(P>0.05).Conclusion:1.The use of TSa1 for 1 week after surgery can improve the post-operative T lymphocyte immune function in patients with HCC,but not with TSa1,it can not improve its cellular immunity.2.The use of TSa1 for 1 week after surgery can reduce transaminase and promote liver function recovery,but not the combined effect is not as effective.