重组改构人肿瘤坏死因子对肺腺癌致恶性胸腔积液封胸治疗的临床疗效分析  

Clinical effects of recombinant mutant human tumor necrosis factor on the malignant pleural effusion induced by lung adenocarcinoma

作　　者：肖鑫武[1] 李倩[1] 宋勇[1] 孙文逵[1] 

机构地区：[1]南京大学医学院附属金陵医院(南京军区南京总医院)呼吸与危重症医学科,南京医学硕士210002

出　　处：《医学研究生学报》2015年第8期836-839,共4页Journal of Medical Postgraduates

基　　金：江苏省临床医学科技专项基金(BL2013026)

摘　　要：目的恶性胸腔积液（malignant pleural effusion,MPE）严重危害晚期肺癌患者生存质量,目前对其尚无理想治疗方法。文中回顾性分析重组改构人肿瘤坏死因子（recombinant human mutant tumor necrosis factor-alpha,rhu-TNF）治疗肺腺癌所致MPE的临床疗效与不良反应。方法回顾性收集2013年3月至2014年7月南京军区南京总医院呼吸与危重症医学科确诊的肺腺癌所致恶性胸膜腔积液患者70例,常规胸腔积液引流后,根据3~4万单位/kg分别以200万单位和300万单位剂量行胸腔内注射rhu-TNF,观察其疗效及不良反应。结果 200万单位和300万单患者有效率分别为75.68%和87.88%,差异无统计学意义（P=0.23）。注药前使用地塞米松的患者不良反应比不使用者明显减轻,差异有统计学意义（P=0.021）,但地塞米松的使用对rhu-TNF的疗效无影响（P=0.486）。结论 rhu-TNF是治疗肺腺癌所致MPE的高效、安全药物。地塞米松可减轻患者不良反应且不影响rhu-TNF疗效。Objective The study aimed to observe the clinical effects and the adverse reactions of recombinant mutant human tumor necrosis factor-alpha （rhu-TNF） on the treatment of malignant pleural effusion （MPE） induced by lung adenocarcinoma. Methods 70 patients with MPE caused by lung adenocarcinoma hospitalized in our department were chosen as the research objects. After conventional drainage of pleural effusion, the patients were divided into two groups according to the weight, respectively receiving intra pleural injection of 2 000000 units and 3 000 000 units of rhu-TNF, followed by the observation of clinical effects and adverse reac- tions. A further retrospective analysis were made on the effects of dexamethasone injected before operation on clinical effects and ad- verse events. Results The effective rates of 2 000 000 unit group and 3 000 000 unit group were respectively 75.68% and 87.88%（P = 0.23 ） , with no statistical difference. The adverse reactions in the group of patients being injected dexamethasone before operation significantly reduced（P = 0. 021 ） and the use of dexamethasone had no influence on the efficacy of rhu-TNF （ P = 0. 486）. Conclusion Rhu-TNF is a safe drug with high efficiency in the treatment of MPE induced by lung ad , and the efficacy and safety of re-peated application in clinic still need more supporting data.

关 键 词：肺腺癌 恶性胸膜腔积液 重组改构人肿瘤坏死因子 治疗 

分 类 号：R734.2[医药卫生—肿瘤]