CIK细胞的心包腔内灌注在恶性心包积液治疗中的临床研究

A clinical research of pericardial cavity perfusion with CIK cells in treatment of malignant pericardial effusion

目的探讨细胞因子诱导的杀伤(CIK)细胞心包腔内灌注治疗恶性心包积液的疗效。方法将45例恶性心包积液患者按治疗方案分为化疗组(n=22)和CIK组(n=23),均行心包腔穿刺引流术,彻底引流心包积液。化疗组患者于心包腔内灌注顺铂(60mg)及地塞米松(5mg);CIK组患者于心包腔内灌注CIK细胞悬液。两组患者定期复查心包积液、血常规、肝功能、肾功能。结果化疗组及CIK组患者治疗的有效率分别为81.8%(18/22)、95.6%(22/23),化疗组患者存在骨髓抑制、胃肠道反应、肝功能及肾功能损害等不良反应;而CIK组患者的上述不良反应均未发生,CIK组患者白细胞减少及胃肠道反应的发生率明显低于化疗组(P<0.05)。结论 CIK细胞心包腔内灌注是一种疗效好、不良反应小、安全性高的治疗恶性心包积液的方法。

Objective To investigate therapeutic efficacy of pericardial cavity perfusion with cytokine induced killer（CIK） ceils in treatment of malignant pericardial effusion. Methods 45 patients with malignant pericardial effusion were divided into chemotherapy group（n=22） and CIK group（n=23） according to therapeutic regime, and were subjected to pericardial cavity puncture drainage in order to drain pericardial effusion completely. Patients in chemotherapy group accepted pericardial cavity perfusion with cisplatin （60 mg） and dexamethasone （5 rag）, and patients in CIK group with CIK cell suspension. Pericardial effusion, blood count, liver and kidney function of patients in both groups were reexamined regularly. Results Treatment efficiency of patients in chemotherapy group and CIK group were 81.8%（18/22）, 95.6%（22/23）, respectively. Adverse reactions such as bone marrow suppression, gastrointestinal reactions, liver and renal function impairment were found in patients in chemotherapy group, and were not in CIK group. Incidence of leukopenia and gastrointestinal reactions of patients in CIK group was lower than that in chemotherapy group（P〈0.05）. Conclusion CIK cells pericardial perfusion is a effective method for treatment of malignant pericardial effusion with features of good efficacy, less adverse reactions and high safety.