重组人血管内皮抑制素联合顺铂胸腔注射治疗非小细胞肺癌合并血性胸腔积液患者的疗效观察  

Efficacy of Intrapleural Injection of Recombinant Human Endostatin Injection Combined with Cisplatin on Treatment of Non-small Cell Lung Cancer with Bloody Pleural Effusion

作　　者：卿松[1] 魏敏[2] 龚道明 何大川 Qing Song;Wei Ming;Gong Daoming;He Dachuan(Department of Thoracic surgery,the People＇s Hospital of Ziyang,Ziyang 641300,China;Cancer Department,the People＇s Hospital of Ziyang,Ziyang 641300,China;Department of Respiratory,the People＇s Hospital of Ziyang,Ziyang 641300,China)

机构地区：[1]资阳市人民医院胸外科,资阳641300 [2]资阳市人民医院肿瘤科,资阳641300 [3]资阳市人民医院呼吸内科,资阳641300

出　　处：《成都医学院学报》2018年第4期487-489,492,共4页Journal of Chengdu Medical College

摘　　要：目的观察重组人血管内皮抑制素联合顺铂治疗晚期非小细胞肺癌(non small-cell lung cancer,NSCLC)合并血性胸腔积液的疗效及其对血、胸水肿瘤标志物的影响及安全性。方法选取2015年2月至2017年2月在资阳市人民医院收治的NSCLC伴血性胸腔积液形成的患者共51例为研究对象,随机分为A、B两组,A组接受重组人血管内皮抑制素联合顺铂胸腔内局部注入,共28例;B组接受顺铂单药胸腔内局部注入,共23例。观察两组局部治疗近期临床疗效、生活质量、毒副反应及肿瘤指标水平的变化。结果 A、B两组的临床疗效有效率分别为67.9%、34.8%,生活质量改善率71.4%、39.1%,差异有统计学意义(P<0.05)。治疗后两组患者血清及胸水CEA、CA125、CA199较治疗前下降,A组较B组水平下降更明显,差异有统计学意义(P<0.05)。两组患者耐受性均较好,无严重不良反应发生。B组治疗后6个月及1年死亡率均高于A组,差异有统计学意义(P<0.05)。结论重组人血管内皮抑制素联合顺铂胸腔内注入治疗NSCLC合并血性胸腔积液近期疗效较好,血、胸水中肿瘤标志物水平降低明显。患者生活质量有明显提高且安全性较高,降低了远期死亡率。Objectives To observe the efficacy and safety of intrapleuraI injection of recombinant human endostatin injection combined with cisplatin on treatment of non small lung cancer（NSCLC） with bloody pleural effusion, via detection of tumor markers in blood and pleural fluid. Methods There were 51 cases of NSCLC patients with bloody pleural effusion were enrolled in this study, among which 28 patients underwent intrapleural injection of recombinant human endostatin injection and cisplatin （A group） and the other 23 patients received injection of cisplatin （group B）. After the local chemotherapy, short-term clinical efficacy, life quality, toxicity and changes in tumor markers levels were observed. Results Efficiency of group A and B were 67.9% and 34.8%, respectively and improvements of the quality life were 71.4% and 39.1%, and the differences between them was statistically significant （P〈0.05） . After the treatment, blood and pleural effusion levels of CEA, CA125, CA199 decreased in both groups and the decline in group A was more significant than that in group B. The differences between the two groups were statistically significant （P〈0.05）. The treatments were well tolerated for all patients without occurrence of serious adverse events. The mortality rates of two groups were observed in 6 months and 1 year after treatment and the mortality in group B was higher than that in group A, the difference was statistically Significant（P〈0.05）. Conclusion IntrapleuraI injection of recombinant human endostatin injection and cisplatin had more desirable short term therapeutic efficacy in treatment for NSCLC combined with bloody pleural effusion and can obviously enhanced the life quality with absence of obvious adverse reactions and reduced long term mortality.

关 键 词：重组人血管内皮抑制素 顺铂 非小细胞肺癌 血性胸腔积液 

分 类 号：R734.2[医药卫生—肿瘤]