洛铂与复方苦参注射液联合应用治疗晚期肺癌恶性胸腔积液的效果及机制  

Therapeutic effects and action mechanism of lobaplatin combined with Kushen injection on malignant pleural effusion in patients with advanced lung cancer

作　　者：刘学军[1] 许金伟[2] 

机构地区：[1]河北省人民医院药剂科,石家庄市050051 [2]河北省人民医院呼吸一科,石家庄市050051

出　　处：《河北医药》2016年第10期1461-1464,共4页Hebei Medical Journal

摘　　要：目的观察洛铂与复方苦参注射液联合应用对晚期肺癌恶性胸腔积液的治疗效果及机制。方法确诊的晚期肺癌合并恶性胸腔积液的患者90例,随机分为洛铂与复方苦参注射液联合组(联合组)、单纯应用洛铂组(洛铂组)、单纯应用顺铂组(顺铂组),每组30例。记录3组治疗效果,并检测3组治疗前后胸腔积液生化指标[乳酸脱氢酶(LDH)、腺苷脱氢酶(AOA)]、肿瘤因子[癌胚抗原(CEA)、糖类抗原(A19-9)]、外周血T细胞亚群(CD3、CD4、CD4/CD8)及胸腔积液脱落细胞的生存素(Survivin)、血管内皮生长因子(VEGF)mRNA的表达情况。结果 3组总有效率比较差异有统计学意义(P<0.05)。联合组不良反应发生率低于其他2组(P<0.05)。治疗后3组患者的生化指标、肿瘤因子、外周血T细胞亚群水平较治疗前均有所改善,联合组各指标改善程度优于洛铂组和顺铂组(P<0.05)。治疗后3组Survivin、VEGF的mRNA均明显下降,联合组变化最为显著(P<0.05)。结论洛铂与复方苦参注射液联合应治疗晚期肺癌恶性胸腔积液有良好的效果,并可有效改善患者相关指标,其机制可能与药物抑制Survivin、VEGF的表达有关。Objective To observe the therapeutic effects of lobaplatin combined with Kushen injection on malignant pleural effusion in patients with advanced lung cancer,and to explore its action mechanism. Methods Ninety patients with advanced lung cancer complicated by malignant pleural effusion were randomly divided into 3 groups： lobaplatin combined with Kushen injection group（ combination group）,lobaplatin group,cisplatin group,with 30 patients in each group. The therapeutic effects were observed and recorded in the three groups. Moreover the biochemical indexes including lactate dehydrogenase（ LDH） adenosine dehydrogenase（ AOA）,tumor markers including carcinoembryonic antigen（ CEA）,saccharide antigen（ A19-9） in pleural effusion and T lymphocyte subsets in peripheral blood including CD3,CD4,CD4/ CD8 as well as the expression levels of mRNA of Survivin,vascular endothelial growth factor（ VEGF） in cast-off cells of pleural effusion were detected by Real time RT-PCR before and after treatment. Results There were significant differences in the total effective rates among three groups（ P〈0. 05）. The incidences of adverse reaction in combination group were significantly lower than those in the other two groups（ P〈0. 05）. After treatment the biochemical indexes,tumor markers,T lymphocyte subsets were improved,as compared with those before treatment in three groups,furthermore,the improvement degree in combination group was superior to that in lobaplatin group or cisplatin group（ P〈0. 05）. After treatment the expression levels of Survivin mRNAS,VEGF mRNA were significantly decreased,especially in combination group（ P〈0. 05）.Conclusion Lobaplatin combined with Kushen injection is obviously effective in treating malignant pleural effusion in patients with advanced lung cancer,which can significantly improve patient ＇s related indexes,and its action mechanism may be correlated to the inhibitive effects of drugs on the expressions of Survivin and VEGF.

关 键 词：肺癌 胸腔积液 洛铂 苦参注射液 药物疗法 检测指标 

分 类 号：R734.2[医药卫生—肿瘤]