秋水仙碱对恶性肿瘤合并心包积液患者的临床疗效  

Clinical efficacy of colchicine on malignant tumor complicated with pericardial effusion

作　　者：陈冠鹏[1] 唐方明[1] 包浔娜[1] 何星球[1] 郑云龙[1] 

机构地区：[1]广东省农垦中心医院心内科,广东湛江524000

出　　处：《包头医学院学报》2018年第1期4-5,18,共3页Journal of Baotou Medical College

基　　金：广东省医学科学技术研究基金项目(A2015599)

摘　　要：目的:分析秋水仙碱对恶性肿瘤合并心包积液的治疗效果。方法:选取2014年11月至2016年11月收治的300例恶性肿瘤合并心包积液患者,按是否需要心包穿刺引流分为A、B两组。A组:经心包超声证实心包积液量较少,临床上无心包填塞症状不需进行心包穿刺引流的患者200例,再随机分为对照组(A1组50例)和观察组(A2组150例);A1组针对原发病及其他症状进行对症支持治疗,A2组在A1组治疗的基础上口服小剂量秋水仙碱(0.5 mg/d)。B组:经心包超声证实大量心包积液或临床上出现心包填塞症状等需要进行心包穿刺引流的患者100例,再随机分为对照组(B1组30例)和观察组(B2组70例);B1组针对原发病、其他症状进行对症支持治疗及心包穿刺置管引流治疗,B2组在B1组的基础上口服小剂量秋水仙碱(0.5 mg/d)。于治疗的第7 d、14 d、21 d、1个月、6个月超声检查A、B两组患者左室舒张末期心包液性暗区的数值及心包纤维化(测量心包厚度)情况。B组如在观察期间再次或多次出现大量心包积液或临床上出现心包填塞症状等需要多次进行心包穿刺引流,则还需记录与上次心包穿刺的间隔时间。A、B两组在研究期间均需多次复查血常规、肝肾功能等以观察可能出现的不良反应。结果:各时间点A、B组中观察组心包积液量少于对照组(P<0.05)、心包纤维化严重程度轻于对照组(P<0.05)。且B组中观察组心包穿刺引流次数少于对照组(P<0.05)。A、B两组未发生明显的不良反应。结论:秋水仙碱能够明显减少恶性肿瘤合并心包积液患者心包积液量,减轻心包纤维化程度,安全性较高。Objective：To analyze the therapeutic efficacy of colchicine on malignant tumor complicated with pericardial effusion.Methods：300 people with malignant tumor complicated with pericardial effusion hospitalized from Nov.2014 to Nov.2016 were divided into Group A（200 patients） and Group B（100 patients） according to the fact whether they need pericardiocentesis.Group A had little pericardial effusion confirmed by pericardial ultrasound and they had no symptoms of cardiac tamponade without any need for pericardiocentesis and were further randomly divided into the control group（50 cases in Group A1） and the observational group（150 cases in Group A2）.Group A1 were given symptomatic and supportive treatment based on their primary disease and other symptoms,while Group A2 were given low dose oral colchicine（0.5 mg/d） on the basis of treatment used Group A1.Group A had much pericardial effusion confirmed by pericardial ultrasound and they had symptoms of cardiac tamponade with need for pericardiocentesis and were further randomly divided into the control group（50 cases in Group B1） and the observational group（70 cases in Group B2）.Group B1 were given symptomatic and supportive treatment and pericardiocentesis based on their primary disease and other symptoms,while Group B2 were given low dose oral colchicine（0.5 mg/d） on the basis of treatment used in Group B1.Then,on the 7th,14th,21th day,1 months and 6 months after the treatment,the value of pericardial fluid in dark zones during left ventricular end diastolic pressure,and pericardial fibrosis（measurement of pericardium thickness） were examined by ultrasound.In Group B,pericardiocentesis should be performed repeatedly if there was much pericardial effusion,or clinical symptoms of pericardial tamponade,with the time of the interval recorded.At the same time,the routine blood test,liver and kidney function were needed to be done repeatedly in both Group A and Group B,with the possible side effects observed.Results：At each time point

关 键 词：秋水仙碱 恶性肿瘤 心包积液 治疗效果 

分 类 号：R542.12[医药卫生—心血管疾病] R730.5[医药卫生—内科学]