化疗联合鸦胆子乳油胸腔内灌注对肺腺癌胸腔积液内炎症因子水平及近期疗效的影响  

Effect of chemotherapy combined with Brucea javanica EC intrathoracic perfusion on inflammatory factor levels and short-term therapeutic efficacy in pleural effusion caused by lung adenocarcinoma

作　　者：高辉[1] 殷玉敬 杨文涛[2] 刘恩 任文清[3] GAO Hui;YIN Yu-jing;YANG Wen-tao;LIU En;REN Wen-qing(Department of General Oncology,Baotou Cancer Hospital,Baotou014030,China;Department of Pathology,Baotou Cancer Hospital,Baotou014030,China;Department of Functional Examination,Baotou Cancer Hospital,Baotou014030,China)

机构地区：[1]内蒙古自治区包头市肿瘤医院肿瘤综合内科,包头014030 [2]内蒙古自治区包头市肿瘤医院病理科,包头014030 [3]内蒙古自治区包头市肿瘤医院功能检查科,包头014030

出　　处：《中国肿瘤临床与康复》2019年第9期1084-1088,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨化疗联合鸦胆子乳油行胸腔内灌注对肺腺癌胸腔积液内炎症因子水平及近期疗效的影响。方法选取2015年1月至2017年12月间包头市肿瘤医院收治的100例肺腺癌合并胸腔积液患者作为研究对象,采用随机数表法分为观察组和对照组,每组50例,观察组患者采用培美曲塞和卡铂联合治疗,观察组患者采用培美曲塞、卡铂联合鸦胆子乳油胸腔灌注治疗,两组患者均治疗4个疗程。观察两组患者胸腔积液近期疗效、肿瘤近期疗效、胸腔积液免疫细胞水平以及炎性因子和不良反应并比较。结果观察组患者的胸腔积液总有效率为80. 0%,显著高于对照组患者的52. 0%,差异有统计学意义(P <0. 05)。观察组患者肿瘤控制率为48. 0%,显著高于对照组患者的32. 0%,差异有统计学意义(P <0. 05)。治疗前,两组患者T细胞亚群水平比较,差异无统计学意义(P> 0. 05)。治疗后,两组患者CD3+、CD4+、CD8+水平、Ig A、Ig M、Ig G和CD4+/CD8+均明显高于治疗前,且观察组均明显高于对照组,差异均有统计学意义(均P <0. 05)。治疗前,两组患者胸腔积液中的TNF-α、IL-6和IL-8比较,差异无统计学意义(P> 0. 05).治疗后,观察组患者的TNF-α、IL-6和IL-8均低于对照组患者,差异均有统计学意义(均P <0. 05)。两组患者骨髓抑制、发热和胸痛等不良反应发生情况比较,差异无统计学意义(P> 0. 05)。结论肺腺癌胸腔积液患者使用化疗联合鸦胆子乳油行胸腔内灌注治疗,胸腔内皮炎性反应降低,患者免疫功能显著改善,能有效治疗胸腔积液,肿瘤控制率良好,建议在临床工作中推广。Objective To study the efficacy of chemotherapy combined with Brucea javanica EC intrathoracic perfusion on Th1/Th2,Treg,inflammatory factor levels and short-term therapeutic effectiveness in pleural effusion associated with lung Adenocarcinoma.Methods One hundred patients with pulmonary adenocarcinoma undergoing pleural effusion at Baotou Cancer Hospital from January 2015 to December2017 were selected as the research subjects.According to the random number table method,they were divided into an observation group and a control group,with 50 patients in each group.The observation group was treated with pemetrexed,carboplatin combined with Brucea javanica for emulsion thoracic perfusion.The control group was treated with pemetrexed combined with carboplatin.Both groups were treated for 4 courses.The short-term treatment efficacy for pleural effusion and tumors,the level of immune cells in pleural effusion and the changes in inflammatory factors and adverse reactions were observed.Results The overall efficacy rate of pleural effusion was 80.0%in the observation group which was significantly higher than 52.0%of the control group.The tumor control rate was 48.0%in the observation group which was significantly higher than 32.0%of the control group.The difference in T-cell subgroup was not statistically significant between the two groups before the treatment(P>0.05).After the treatment,the levels of CD3+,CD4+,CD8+,Ig A,Ig M,Ig G,and CD4+/CD8+were significantly higher in the two groups than before the treatment,and the above levels were significantly higher in the observation group than in the control group(all P<0.05).There was no significant difference in the levels of TNF-a,IL-6 and IL-8 between the two groups before the treatment(P>0.05).After the treatment,the levels of TNF-a,IL-6 and IL-8 were significantly decreased in the two groups,and the levels of TNF-a,IL-6 and IL-8 were significantly lower in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of a

关 键 词：肺腺肿瘤 鸦胆子乳油 培美曲塞 胸腔积液 炎性因子 

分 类 号：R734.2[医药卫生—肿瘤]