卡铂联合白介素-2治疗恶性心包积液  

Treatment of malignant pericardial effusion by carboplatin combined with interleukin-2

作　　者：陈良[1] 张颖[1] 张道良[1] 顾月清[1] 

机构地区：[1]上海交通大学胸科医院急诊科,上海200030

出　　处：《国际病理科学与临床杂志》2012年第6期504-507,共4页Journal of International Pathology and Clinical Medicine

摘　　要：目的:观察引流心包积液后,行卡铂联合白介素-2腔内注射治疗恶性心包积液的疗效及安全性。方法:收集53例恶性心包积液患者,先用中心静脉导管行经皮穿刺心包置管引流,待积液基本引尽后,随机抽取12例(卡铂组)经导管注入卡铂300 mg,13例(白介素组)注入白介素-2 200万U,28例(联合治疗组)同时注入卡铂300 mg和白介素-2 200万U,保留48 h后抽净积液,拔管,并作随访。结果:所有患者经治疗后,卡铂组完全缓解(complete response,CR)5例(41.7%),部分缓解(partial response,PR)3例(25.0%),无效(no change,NC)4例(33.3%),总有效率66.7%;白介素组CR 4例(30.8%),PR 4例(30.8%),NC 5例(38.4%),总有效率61.6%;联合治疗组CR 18例(64.3%),PR 9例(32.1%),NC 1例(3.6%),总有效率96.4%。无1例发生穿刺意外;卡铂组1例(8.3%)、联合治疗组2例(7.1%)出现轻度恶心、胃纳轻度减低,胃复安、维生素B6对症治疗后短期好转,白介素组无胃肠反应发生;白介素组2例(15.4%)、联合治疗组5例(17.9%)出现轻度胸痛和低热,用新癀片或吲哚美辛栓剂可控制,卡铂组无胸痛、发热表现;随访2周,无1例发生骨髓抑制;随访3月,无1例发生缩窄性心包炎。结论:卡铂联合白介素-2治疗恶性心包积液安全、有效,值得临床推广应用。Objective： To observe the clinical efficacy and safety of intrapericardial injection of carboplatin combined with interleukin-2 for malignant paricardial effusion. Methods： Fifty-three patients with malignant paricardial effusion were received percutancous pericardiocentesis with central venous catheter for continuous drainage. Three hundred milligrams of carboplatin was injected through catheter into paricardial cavity in 12 cases （carboplatin group）; 2 million units of interleukin-2 was done in 13 cases （interleukin group）; and 3 hundred milligrams of carboplatin plus 2 million units of interleukin-2 was done in 28 cases （combination group） after the effusion had been drained. The residual effusion was drawn out after the drugs had been retained for 48 h. Finally, the catheter was pulled out. Results： In carboplatin group, 5 cases （41.7%） were complete response （CR）, 3 （25.0%） partial response （PR）, 4（33.3%） no change （NC） after the treatment, and the total effective rate was 66.7%. Inthe interleukin group, 4 cases （30.8%） were CR, 4 （30.8%） PR, 5 （38.4%） NC, and the total effective rate was 61.6%. In the combination group, 18 （64.3%） were CR, 8 （32.1%） PR, 1（3.6%） NC, and the total effective rate was 96.4%. No accident of puncture occured. Only 1 case （8.3%） in the carboplatin group, 2 cases （7.1%） in the combination group showed side effects of mild nausea and slightly reduction of appetite which were reduced after the treatment by metoclopramide and vitamin B6. Two （15.4%） cases in the interleukin group, 5 （17.9%） cases in the combination group （no one in the carboplatin group） showed mild chest pain and low fever who were eased by Xinghuangpian or Indomethacin suppository. No bone marrow suppression and no constrictive pericarditis was seen after 2-week or 3-month follow-up, respectively. Conclusion： Treatment of malignant paricardial effusion by carboplatin combined with interleukin-2 is safe and effective, and is worth

关 键 词：卡铂 白介素 2 恶性心包积液 

分 类 号：R730.5[医药卫生—肿瘤]