重组人血管内皮抑制素联合白介素-Ⅱ胸腔内注射治疗癌性胸水的近期疗效观察

Clinical observation of endostar combined with interleukin-Ⅱ intrathoracic injection in the treatment of malignant thoracic effusion

目的观察重组人血管内皮抑制素(恩度)联合白介素-Ⅱ胸腔内注射治疗癌性胸水的临床疗效、生活质量及副作用。方法将80例癌性胸水患者随机分成恩度联合白介素-Ⅱ组(观察组)和单纯白介素-Ⅱ组(对照组)各40例,用一次性单腔中心静脉导管胸腔置管引流胸水至日胸水流出量小于100 ml后,观察组给予胸腔内先后注入白介素-Ⅱ(100万单位)联合恩度(45 mg)治疗。对照组仅给予胸腔内注入白介素-Ⅱ(100万单位)治疗。4周后根据胸腔超声结果观察癌性胸水控制情况,以及患者生活质量评分,同时观察两组用药期间的不良反应。结果观察组治疗癌性胸水总有效率为70.0%,明显高于对照组(47.5%),差异具有统计学意义(P<0.05),观察组生活质量评分高于对照组,差异具有统计学意义(P<0.05)。观察组不良反应与对照组相似,并未明显增加。结论重组人血管内皮抑制素(恩度)联合白介素-Ⅱ胸腔内注射较单纯注入白介素-Ⅱ对控制癌性胸水能更有效,同时明显改善患者生活质量,临床不良反应较单纯注入白介素-Ⅱ相似,值得临床重视。

Objective To observe the clinical effect, life quality and side effects of human recombinant endostatin （endostar） combined with interleukin- Ⅱ intrathoracic injection in the treatment of malignant thoracic effusion. Methods The malignant pleural effusion of 80 patients were drained with disposable single lumen central venous catheter to daily drainage less then 100ml, and then all patients were randomly divided into the observation group （intrathoracic injection with 45mg cndostar combined with 1 million units interleukin- I[ ） and the control group （ intrathoracic injection with 1 million units interleukin- II ）. The effective rate, quality of life （QOL） , drug adverse reaction and clinical efficacy were evaluated after the intrathoracic injection by thoracic ultrasound. Results The to- tal effective rate in the treatment group was 70. 0%, which was significantly higher than that in the control group （47.5%） （P 〈0. 05）. The score of QOL was obviously higher in the observation group than in the control group （P 〈 0. 05）. There was no significant difference in drug adverse reaction between the two groups. Conclusion Thorac- ic injection of endostar with interleukin-Ⅱ has better short-term efficacy without obvious adverse reactions in the treat- ment of cancer with malignant thoracic effusion.