老年基因野生型非小细胞肺癌合并胸腔积液引流灌注联合PD-1抑制剂的疗效及安全性分析  

Efficacy and Safety Analysis of Elderly Wild-type Non-small Cell Lung Cancer with Pleural Effusion Drainage and Perfusion Combined with PD-1 Inhibitor

作　　者：范仁亮 Fan Renliang(Department of Oncology,the First Hospital of Nanping City,Nanping,Fujian Province,353000 China)

机构地区：[1]福建省南平市第一医院肿瘤内科,福建南平353000

出　　处：《中外医疗》2021年第34期1-4,9,共5页China & Foreign Medical Treatment

摘　　要：目的探讨引流灌注联合PD-1抑制剂对老年基因野生型非小细胞肺癌合并胸腔积液患者疗效及安全性分析。方法方便收集2018年7月—2020年7月在该院住院治疗的120例老年基因野生型非小细胞肺癌合并胸腔积液患者作为研究对象,按照随机数字法将120患者分为引流组、联合组,各60例,所有患者均进行者经B超定位后行胸腔闭式引流术,联合组在上述治疗方案上采用3 mg/kg纳武利尤单抗注射液治疗,观察两组患者胸腔积液疗效、免疫功能、血清VEGF及CYFRA21-1及SCC水平及不良反应。结果引流组患者胸腔积液临床有效率为68.33%低于联合组胸腔积液临床有效率88.33%,差异有统计学意义(χ^(2)=7.070,P<0.05)。与治疗前相比,治疗后两组患者CD4^(+)及CD4^(+)/CD8^(+)水平升高,CD8^(+)降低,差异有统计学意义(P<0.05),且与引流组相比,联合组CD4^(+)及CD4^(+)/CD8^(+)水平升高,CD8^(+)降低,差异有统计学意义(P<0.05)。与治疗前相比,治疗后两组患者VEGF、CYFRA21-1及SCC水平降低,差异有统计学意义(P<0.05),且与引流组相比,联合组VEGF、CYFRA21-1及SCC水平降低,差异有统计学意义(P<0.05)。引流组患者不良反应的发生率为48.33%(29/60)高于联合组患者不良反应发生率25.00%(15/60),差异有统计学意义(χ^(2)=7.033,P<0.05)。结论胸腔置管闭式引流联合PD-1抑制剂能够增加基因野生型非小细胞肺癌合并胸腔积液患者疗效,能够通过抑制VEGF及肿瘤标志物水平,提高患者免疫功能,且不良反应较少,值得推广。Objective To investigate the efficacy and safety of drainage and perfusion combined with PD-1 inhibitor in elderly patients with wild-type non-small cell lung cancer with pleural effusion.Methods Conveniently selected 120 elderly wild-type non-small cell lung cancer patients with pleural effusion who were hospitalized in the hospital from July 2018 to July 2020 were collected as the research objects.According to the random number method,120 patients were divided into drainage group and combined group,60 cases in each group,all patients underwent closed thoracic drainage after B-ultrasound positioning.The combined group was treated with 3 mg/kg nivolumab injection on the above treatment plan.Observed the efficacy of pleural effusion in the two groups,immune function,serum VEGF,CYFRA21-1 and SCC levels and adverse reactions.Results The clinical effective rate of pleural effusion in the drainage group was 68.33%,which was lower than the clinical effective rate of pleural effusion in the combined group was88.33%,the difference was statistically significant(χ^(2)=7.070,P<0.05).Compared with before treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)increased and CD8^(+)decreased in the two groups after treatment,the difference was statistically significant(P<0.05).Compared with the drainage group,the levels of CD4^(+)and CD4^(+)/CD8^(+)increased and CD8^(+)decreased in the combined group,the difference was statistically significant(P<0.05).Compared with before treatment,the levels of VEGF,CYFRA21-1 and SCC in the two groups decreased significantly after treatment,the difference was statistically significant(P<0.05),and compared with the drainage group,the levels of VEGF,CYFRA21-1 and SCC in the combined group decreased significantly,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the drainage group was 48.33%(29/60)the incidence of adverse reactions was higher than that of the combined group by 25.00%(15/60),there was a difference between the two groups,the difference was stat

关 键 词：非小细胞肺癌 胸腔恶性积液 胸腔置管闭式引流 PD-1抑制剂 

分 类 号：R97[医药卫生—药品]