重组改构人肿瘤坏死因子-α治疗老年非小细胞肺癌恶性胸腹水1例并文献复习  

Recombinant human tumor necrosis factor-alpha in treatment of malignant pleuroperitoneal cavity effusion in elderly patients with non-small cell lung cancer: A case report and review of literature

作　　者：汪海涛[1] 林洁[1] 朱宏丽[1] 冉海红[1] 

机构地区：[1]解放军总医院南楼血液科,北京100853

出　　处：《解放军医学院学报》2013年第8期869-872,共4页Academic Journal of Chinese PLA Medical School

基　　金："重大新药创制"科技重大专项(2008ZXJ09001-019);中央保健专项资金科研课题(B2009B115)~~

摘　　要：目的报告1例重组改构人肿瘤坏死因子-α(rmhTNF-α)治疗老年恶性胸、腹腔积液的临床病例。方法 2010年我科收治1例肺癌并胸腹腔积液患者,给予留置胸腔和腹腔引流管,每天放尽胸、腹水并记录引流量后,分别注入地塞米松磷酸钠注射液2 mg、5 mg,然后分别将rmhTNF-α200万U、500万U溶于20 ml 0.9%氯化钠注射液并注入胸、腹腔。并通过治疗前后引流量变化、影像学变化、血制品的用量和输血时间间隔来评价疗效。结果 rmhTNF-α能有效控制进展期肺癌患者的恶性胸腹水,治疗后肺部CT、腹部B超显示胸腹水减少,胸腹水引流量减少(P<0.01),输注血制品的总量减少、时间间隔延长。结论 rmhTNF-α可能对常规治疗无效的恶性浆膜腔积液有效,但机制还不甚明了,有待进一步系统研究。Objective To report the recombinant human tumor necrosis factor-alpha（rmhTNF-α） in treatment of malignant pleuroperitoneal cavity effusion in an elderly patient with non-small cell lung cancer（NSCLC）.Methods A drainage tube was placed in a lung cancer patient with pleuroperitoneal cavity effusion admitted to our department in 2010 to drain the pleuroperitoneal cavity effusion every day with its volume recorded,followed by injection of 2 mg and 5 mg dexamethasone and 20 ml normal saline containing 2×106U/5×106 U rmhTNF-α into the pleuroperitoneal cavity.The therapeutic effect was assessed by measuring the volume of drained pleuroperitoneal effusion,imaging,infusion amount of blood products,and blood transfusion interval.Results The rmhTNF-α could effectively control the malignant pleuroperitoneal cavity effusion in patients with progressive lung cancer,with their pleuroperitoneal cavity effusion and infusion amount of blood products reduced,and their blood transfusion interval shortened after treatment as shown in lung CT and abdominal ultrasongraphy（P0.01）.Conclusion The rmhTNF-α is effective for malignant pleuroperitoneal effusion failing to conventional treatment.However,its mechanism is still unclear,thus needing to be further studied.

关 键 词：肿瘤坏死因子-Α 非小细胞肺癌 恶性腹水 恶性胸水 老年人 

分 类 号：R734.2[医药卫生—肿瘤]