异甘草酸镁联合华蟾素治疗恶性胸腹腔积液的临床观察  

Clinical observation of Magnesium isoglycyrrhizinate combined with Cinobufacini in patients with malignant pleural effusion or ascites

作　　者：徐君南 李美静[1] 李晓睿[1] 董方圆 高志超 孙涛[1,2] Xu Junnan;Li Meijing;Li Xiaorui;Dong Fangyuan;Gao Zhichao;Sun Tao(Department of Medical Oncology,Cancer Hospital of China Medical University,Liaoning Cancer Hospital ＆ Institute,Liaoning Shenyang 110042,China;Key Laboratory of Liaoning Breast Cancer Research,Liaoning Shenyang 110042,China.)

机构地区：[1]中国医科大学附属肿瘤医院,辽宁省肿瘤医院乳腺内科,辽宁沈阳110042 [2]辽宁省乳腺癌研究重点实验室,辽宁沈阳110042

出　　处：《现代肿瘤医学》2018年第18期2871-2874,共4页Journal of Modern Oncology

基　　金：中国医疗手牵手工程委员会/北京医学奖励基金会项目(编号:YJHYXKYJJ-150);中央引导地方科技发展专项(编号:2016007011);辽宁省自然科学基金(编号:2015020251);辽宁省省直临床能力建设项目(编号:LNCCC-C05-2015)

摘　　要：目的:观察胸腹腔内注射华蟾素联合异甘草酸镁静脉注射液对恶性胸腹腔积液的控制作用及其安全性,并探索体外药敏检测结果和疗效预测因子。方法:收集27例恶性胸腹腔积液患者分为华蟾素单药组和华蟾素联合异甘草酸镁联合组,根据症状缓解情况和无穿刺引流间隔时间(PDFI)来评估疗效,汇总不良反应并分析体外药敏检测结果,以及积液中淋巴细胞和肿瘤细胞比值(LTR)对于疗效的预测作用。结果:27例恶性胸腹腔积液患者经治疗后,均有不同程度的症状缓解和改善,其中联合组有1例患者胸腔积液出现影像学完全缓解。与单药组相比,联合组中位PDFI较单药组更长(10周 vs 7周)。联合组药物直接相关的腹痛等不良反应发生率更低(28.6% vs 7.7%)。体外药敏结果显示,与单药组相比,联合组肿瘤抑制率更高。生物标志物探索性结果显示,与PDFI短者(<2个月)相比,LTR在长期有效的患者(PDFI≥2个月)中更高。结论:华蟾素联合异甘草酸镁静脉滴注对恶性胸腹腔积液有一定的控制作用,安全性好,积液中高LTR比值提示良好预后。Objective： To observe the efficacy and safety of Magnesium isoglycyrrhizinate combined with Cinobufacini in patients with malignant pleural effusion or ascites,and further to investigate chemosensitivity and potential predictive factors.Methods： Twenty-seven patients with malignant pleural effusion or ascites were enrolled and randomly individe into two groups： Cinobufacini monotherapy,and Magnesium isoglycyrrhizinate combined with Cinobufacini,clinical response were confirmed by symptom relief and puncture and drainage-free interval（ PDFI）,side effects records,chemosensitivity test results and ratio of lymphocyte and tumor cell（ LTR） were collected.Results： Twenty-seven patients reported some degree of symptom relief.One patient with pleural effusion was confirmed complete remission.Compared with monotherapy group,combined group had longer median PDFI,10 weeks and 7 weeks.Drug-related adverse events,such as abdominal pain,were less in combined group（ 28.6% vs 7.7%）.Correlation between higher LTR and higher inhibiting ratio with patients with PDFI more than two months,patients with high LTR might benefit more from the therapy.Conclusion： Magnesium isoglycyrrhizinate combined with Cinobufacini was effective and tolerable in malignant effusion.Higher LTR in effusion may predict better prognosis.

关 键 词：异甘草酸镁 胸腔积液 腹腔积液 华蟾素 

分 类 号：R730.6[医药卫生—肿瘤]