胸腺肽α_1联合顺铂、高聚金葡素治疗胃癌合并恶性腹腔积液的临床观察  

Clinical Observation of Thymosin α_1 Combined with Cisplatin and Highly Agglutinated Staphylococcin for Gastric Cancer Complicating with Malignant Ascites

作　　者：李艳君[1] 

机构地区：[1]辽宁医学院附属第三医院肿瘤二科,辽宁锦州121001

出　　处：《中国药房》2014年第20期1856-1858,共3页China Pharmacy

摘　　要：目的：观察胸腺肽α1联合顺铂、高聚金葡素治疗胃癌合并恶性腹腔积液的临床疗效和安全性。方法：86例胃癌合并恶性腹腔积液患者按抽签法分为观察组（44例）和对照组（42例）。两组患者治疗前均行常规腹腔穿刺置管引流术，缓慢引流腹腔积液，引流量在1000-3000ml，放液速度需缓慢，以免发生低血压和休克，需超声检查证实放完腹腔积液，并辅以一定的蛋白质和电解质。在此基础上对照组患者给予顺铂100mg加入0．9％氯化钠注射液1000ml中腹腔灌注，每3周1次；高聚金葡素5000U腔内注射，每周1次。观察组患者在对照组治疗的基础上给予胸腺肽α1 1．6mg加入注射用水1ml中，溶解后立即皮下注射，每周2次，每次间隔3d。两组患者疗程均为4周。观察两组患者临床疗效、毒性反应、免疫学指标（T淋巴细胞亚群CD3＋、CD4＋、CD47CD8＋）、随访12个月的生存率及不良反发生情况。结果：治疗后观察组患者总有效率显著高于对照组，毒性反应发生率显著低于对照组，差异均有统计学意义（P〈0．05）。治疗前两组患者CD3＋、CD4＋、CD4＋／CD8＋比较，差异无统计学意义（P〉0．05）；治疗后两组患者CD3＋、CD4＋／CD8＋显著高于同组治疗前，且观察组高于对照组，CD4＋显著低于同组治疗前，且观察组低于对照组，差异均有统计学意义（P〈0．05）。观察组患者生存率显著高于对照组，差异有统计学意义（P〈0．05）。两组患者均未见明显心、肾毒性。结论：胸腺肽α1联合顺铂、高聚金葡素治疗胃癌合并恶性腹腔积液疗效显著，安全性较好。OBJECTIVE： To observe the clinical efficacy and safety of Thymosin α1 combined with cisplatin and highly aggluti nated staphylococcin （HAS） for gastric cancer complicating with malignant ascites. METHODS： 86 gastric cancer patients with malignant ascites were randomly divided into observation group （44 cases） and control group （42 cases） by lottery. Both groups received abdominal puncture catheter drainage before treatment, amount of drainage within 1 000 ml-3 000 ml; to avoid hypopiesia and shock, the ascites should be discharged slowly; the completion of ascites drainage should be checked by ultrasonic examination, and certain protein and electrolyte were also provided. Control group received cisplatin 100 mg added into 0.9% Sodium chloride injection 1 000 ml intraperitoneally every 3 weeks, and HAS 5 000 U intraperitoneally once a week. Observation group was additional given hypodermical injection of Thymosin α1 1.6 mg added into aquae pro injectione 1 ml immediately after dissolving twice a week, every 3 days. Treatment courses of 2 groups lasted for 4 weeks. Therapeutic efficacy, toxic response, Immunology index and ADR were observed in 2 groups. Survival rate and ADR were observed within 12 months. RESULTS： Total effective rate of observation group was significantly higher than that of control group. The incidence of toxic response in observation group was significantly lower than in control group; there was statistical significance （P〈0.05）. There was no statistical significance in the difference of CD3＋, CD4＋ and CD4＋/CD8＋ between 2 groups before treatment （P〉0.05） ; CD3＋ and CD4＋/CD8＋ of 2 groups after treatment were significantly higher than before, and those of observation group was higher than those of control group; CD4＋ of 2 groups after treatment were significantly lower than before; that of observation group was significantly lower than that of control group; there was statistical significance （P〈0.05）. No heart toxicity and nephrotoxicity was

关 键 词：胸腺肽Α1 顺铂 高聚金葡素 胃癌 恶性腹腔积液 

分 类 号：R734.2[医药卫生—肿瘤]