癌性胸水胸腔热化疗对淋巴细胞亚群变化的临床意义

The influence of hyperthermic chemotherapy intra-pleural cavity on ymphocyte subsets in patients with malignant hydrothorax

目的研究癌性胸水胸腔持续灌注热化疗对淋巴细胞亚群的变化。方法在全麻下对21例癌性胸水患者，内置二根胸管，出胸水管连接水封瓶，经过人工心肺机的灌注泵，接上铝制螺纹管（变温用），连接进胸水管入胸腔，向胸水中加入化疗药物顺铂200～250mg／m^2，保持胸水温度42～45℃，持续灌注60min左右，于术前、术后第3、7d、2周分别作淋巴细胞亚群测定，以了解胸腔热化疗对免疫功能的影响。结果热化疗后CD19、CD25的表达率明显增高（P〈0．05和〈0．01）。结论胸腔持续灌注热化疗使癌性胸水缓解率明显提高，是一种安全、有效的治疗癌性胸水的好方法，而且能使B淋巴细胞免疫功能及T淋巴细胞活化率明显提高。

Objective To study the effect of immunological function of pleural eavicty hyperthermic therapy. Methods After induction of geberal anaesthesia, 21 malignant hydrothorax patiens had two chest tubes in the thoracic cavity. The therapeutic solution （ physiological saline） was added cisplatin 200 - 250 mg/m^2 and warmed to 42 -45＆ordm; C, continusly perfused to the thoracic cavty lasting about 60 minutes. The lymphocyte subsets of blood at pre -operation,3rd, 7th and 2nd week dfter operation were detected. Results After hyperthermie chemotherapy, CD19 and CD25 were much higher than befor （ P 〈 0. 05, P 〈 0. 01 ）. Conclusion Pleural cavity continuous perfusion of hyperthermie chemotherapy obviously elevated the remission rate of malignant hydrethorax. It is a safe and effective method for treating malignant hydrothorax. It can significantly elevate the immune function of B cell and aetivative rate of T cell.