血凝酶、重组人血管内皮抑制素联合顺铂胸腔灌注治疗恶性胸腔积液的效果及对血清VEGF水平影响分析  

Analysis of the Effect of Hemocoagulase and Recombinant Human Endostatin Combined with Cisplatin Thoracic Perfusion in the Treatment of Malignant Pleural Effusion and the Effect on Serum VEGF Level

作　　者：徐冠军 时毓 傅敬忠 XU Guanjun;SHI Yu;FU Jingzhong(Jiujiang Third People's Hospital,Jiangxi Province,Jiujiang 332000,China;不详)

机构地区：[1]江西省九江市第三人民医院,江西九江332000

出　　处：《中国医学创新》2023年第12期51-55,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP220217767)。

摘　　要：目的:探讨血凝酶、重组人血管内皮抑制素联合顺铂胸腔灌注治疗恶性胸腔积液的效果及对血清血管内皮生长因子(VEGF)水平的影响。方法:回顾性分析2019年10月-2020年10月九江市第三人民医院收治的90例恶性胸腔积液患者的临床资料,按照治疗方法不同进行分组,三联组患者(n=50)采用血凝酶、重组人血管内皮抑制素联合顺铂胸腔灌注治疗,二联组患者(n=40)采用重组人血管内皮抑制素联合顺铂胸腔灌注治疗。比较两组患者临床疗效,不良反应发生情况,于治疗前、治疗第7天、治疗第14天、治疗后7 d、治疗后14 d评估血清VEGF水平和Karnofsky功能状态评分的变化情况;术后常规随访,采用Kaplan-Meier生存分析两组患者的生存情况。结果:三联组患者的客观有效率高于二联组,差异有统计学意义(P<0.05);两组患者治疗后发生的不良反应均为Ⅰ~Ⅱ级,且在发热、恶心呕吐、胸痛和骨髓抑制等不良反应发生率上,差异均无统计学意义(P>0.05);三联组治疗第14天、治疗后7 d和治疗后14 d的血清VEGF水平均低于二联组,三联组治疗后7 d和治疗后14 d的Karnofsky功能状态评分均高于二联组,差异均有统计学意义(P<0.05);三联组的总生存率优于二联组,差异有统计学意义(P<0.05)。结论:血凝酶、重组人血管内皮抑制素联合顺铂胸腔灌注治疗可提高恶性胸腔积液的治疗效果,有效减少血清VEGF的含量,延长患者的生存时间,且无明显不良反应的增加,对患者生活质量影响更小。Objective:To investigate the curative effect of Hemocoagulase,Recombinant Human Endostatin combined with Cisplatin in the treatment of malignant pleural effusion and its effect on serum VEGF level.Method:The clinical data of 90 patients with malignant pleural effusion admitted to Jiujiang Third People's hospital from October 2019 to October 2020 were retrospectively analyzed,and they were divided into groups according to different treatment methods.Patients in the triple combination group(n=50)were treated with Hemocoagulase,Recombinant Human Endostatin and Cisplatin intrapleural infusion,while patients in the dual combination group(n=40)were treated with Recombinant Human Endostatin and Cisplatin intrapleural infusion.The clinical efficacy and adverse reactions of the two groups were compared,and the changes of serum VEGF level and Karnofsky functional status scores were evaluated before treatment,on the 7th day of treatment,on the 14th day of treatment,7 days after treatment,and 14 days after treatment;routine follow-up,Kaplan-Meier survival analysis was used to analyze the survival of the two groups of patients.Result:The objective response rate of the triple combination group was higher than that of the dual combination group,the difference was statistically significant(P<0.05);the adverse reactions occurred after treatment in both groups were gradeⅠtoⅡ,and there were no statistically significant differences in the incidences of adverse reactions such as fever,nausea,vomiting,chest pain,and bone marrow suppression(P>0.05);the serum VEGF levels in the triple combination group on the 14th day of treatment,7 days after treatment and 14 days after treatment were lower than those in the dual combination group,the Karnofsky functional status scores at 7 days and 14 days after treatment in the triple combination group were higher than those in the dual combination group,the differences were statistically significant(P<0.05);the overall survival rate of the triple combination group was better than that of the dua

关 键 词：血凝酶 重组人血管内皮抑制素 顺铂 胸腔灌注 恶性胸腔积液 

分 类 号：R730.5[医药卫生—肿瘤]