目的 探究注射用雷替曲塞聯(lián)合注射用鹽酸吉西他濱治療原發(fā)性肝癌的臨床療效。方法 選取2013年3月-2016年3月天津市寶坻區(qū)人民醫(yī)院收治的不可手術切除原發(fā)性肝癌患者118例，隨機分為對照組和治療組，每組各59例。對照組于治療開始的1、8、15 d靜脈滴注注射用鹽酸吉西他濱，1 000 mg/m²加入到0.9%氯化鈉注射液50 mL中（可進一步稀釋），給藥時間30 min，21 d為一個療程；治療組在對照組基礎上靜脈滴注注射用雷替曲塞，3 mg/m²加入到0.9%氯化鈉注射液50~250 mL中，給藥時間15 min，每21天給藥1次。兩組患者均治療42 d。觀察兩組的臨床療效，比較兩組的生存質量和血清學指標情況。結果 治療后，對照組和治療組的有效率分別為38.98%、57.63%，疾病控制率分別為77.97%、89.83%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，對照組和治療組的生存質量改善率分別為81.36%、91.53%，兩組比較差異具有顯著性（P<0.05）。治療后，兩組甲胎蛋白（AFP）、癌胚抗原（CEA）水平均顯著下降，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；且治療組這些觀察指標的下降程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結論 注射用雷替曲塞聯(lián)合注射用鹽酸吉西他濱治療原發(fā)性肝癌具有較好的臨床療效，能改善生存質量，調節(jié)血清學指標，具有一定的臨床推廣應用價值。

Objective To investigate the clinical effect of Raltitrexed for injection combined with Gemcitabine Hydrochloride for injection in treatment of primary liver cancer. Methods Patients (118 cases) with unresectable primary liver cancer in Tianjin Baodi People's Hospital from March 2013 to March 2016 were randomly divided into control and treatment groups, and each group had 59 cases. Patients in the control group were iv administered with Gemcitabine Hydrochloride for injection at 1, 8, 15 d, 1 000 mg/m² added into normal saline 50 mL (may be further diluted), the administration time was 30 min, 21 d for a course. Patients in the treatment group were iv administered with Raltitrexed for injection on the basis of the control group, 3 mg/m² added into normal saline 50-250 mL, the administration time was 15 min, once every 21 d. Patients in two groups were treated for 42 d. After treatment, the clinical efficacies were evaluated, and quality of life and serological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 38.98% and 57.63%, respectively; the disease control rates in the control and treatment groups were 77.97% and 89.83%, respectively, and there were difference between two groups (P<0.05). After treatment, the improvement rates of life quality in the control and treatment groups were 81.36% and 91.53%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of AFP and CEA in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Raltitrexed for injection combined with Gemcitabine Hydrochloride for injection has clinical curative effect in treatment of primary liver cancer, can improve quality of life, and regulate serological index, which has a certain clinical application value.