华蟾素联合重组人血管内皮抑素胸腔灌注治疗恶性胸腔积液的临床研究  

Clinical research of pleural perfusion of Cinobufacini combined with recombinant human endostatin in the treatment of malignant pleural perfusion

作　　者：米虽才 吴玲艳[1] 罗建文[1] 杨清蓉[1] 

机构地区：[1]厦门市中医院,福建厦门361001

出　　处：《中医临床研究》2016年第30期112-113,120,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:观察重组人血管内皮抑素联合华蟾素腔内灌注治疗恶性胸腔积液的疗效及安全性。方法:将42例恶性胸腔积液患者随机分为华蟾素联合重组人血管内皮抑素组及单药顺铂组。均采用胸腔穿刺置管,分次充分引流胸水后,治疗组采用华蟾素30 m L、重组人血管内皮抑素60 mg稀释后行胸腔灌注治疗,每周2次,最多4次为1个疗程。对照组采用顺铂30~40 mg稀释后行胸腔灌注,每周2次,最多4次为1个疗程。按照WHO胸腔积液评价标准和NCI-CTCAE 3.0分级标准分别评估疗效及不良反应。结果:治疗组总有效率为57.1%,优于对照组总有效率35.7%(x^2=4.87,P=0.019);治疗组无进展生存期95 d,亦明显高于对照组53 d(x^2=3.72,P=0.038)。全组无IV级不良反应发生,对照组在中性粒细胞减少、恶心、呕吐等方面发生率高于治疗组。结论:华蟾素药联合重组人血管内皮抑素腔内治疗恶性胸腔积液有效,且疗效优于顺铂,其安全性较好,值得临床进一步探索。Objective： To observe the efficacy and safety of pleura1 perfusion of Cinobufacini combined with recombinant human endostatin in the treatment of malignant pleural perfusion. Methods： 42 patients with malignant pleural perfusion were randomly divided into Cinobufacini combined with recombinant human endostatin group and Cisplatin group. Both groups received pleural puncture catheter and several drainage of pleural effusion, the treatment group received pleural perfusion of Cinobufacini （30 mL） combined with recombinant human endostatin （60 mg） after dilution, twice a week and utmost 4 weeks formed one treatment course. The control group received pleural perfusion of Cisplatin （30 - 40 mg） after dilution, twice a week and utmost 4 weeks formed one treatment course. The curative effect and adverse reaction were evaluated respectively according to the WHO pleural effusion evaluation standard and NCI-CTCAE 3.0 grading standard. Results： The total effective rate of the treatment group was 57.1%, which was significantly higher than that of the control group, 35.7% （χ^2=4.87, P=-0.019）; the progression free survival of the treatment group was 95 d, which was significantly higher than that of the control group, 53 d （χ ^2=3.72, P=0.038）. There was no IV adverse reaction in the treatment group. The incidence rate of control group was higher than that of treatment group in the incidence of neutropenia, nausea, vomiting, etc. Conclusion： Pleural perfusion of Cinobufacini combined with recombinant human endostatin had better effect than Cisplatin in the treatment of malignant pleural perfusion, it was of high safety and was worthy of further clinical exploration.

关 键 词：华蟾素 重组人血管内皮抑素 恶性胸腔积液 胸腔灌注 

分 类 号：R730.6[医药卫生—肿瘤]