目的 探究注射用雷替曲塞联合注射用盐酸吉西他滨治疗原发性肝癌的临床疗效。方法 选取2013年3月-2016年3月天津市宝坻区人民医院收治的不可手术切除原发性肝癌患者118例，随机分为对照组和治疗组，每组各59例。对照组于治疗开始的1、8、15 d静脉滴注注射用盐酸吉西他滨，1 000 mg/m²加入到0.9%氯化钠注射液50 mL中（可进一步稀释），给药时间30 min，21 d为一个疗程；治疗组在对照组基础上静脉滴注注射用雷替曲塞，3 mg/m²加入到0.9%氯化钠注射液50~250 mL中，给药时间15 min，每21天给药1次。两组患者均治疗42 d。观察两组的临床疗效，比较两组的生存质量和血清学指标情况。结果 治疗后，对照组和治疗组的有效率分别为38.98%、57.63%，疾病控制率分别为77.97%、89.83%，两组比较差异有统计学意义（P<0.05）。治疗后，对照组和治疗组的生存质量改善率分别为81.36%、91.53%，两组比较差异具有显著性（P<0.05）。治疗后，两组甲胎蛋白（AFP）、癌胚抗原（CEA）水平均显著下降，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗组这些观察指标的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 注射用雷替曲塞联合注射用盐酸吉西他滨治疗原发性肝癌具有较好的临床疗效，能改善生存质量，调节血清学指标，具有一定的临床推广应用价值。

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.