溶链菌制剂联合丝裂霉素与香菇多糖联合丝裂霉素胸腔灌注治疗恶性胸腔积液的疗效研究

Effect of Group A Streptococcus Preparation combined with mitomycin and lentinan combined with mitomy-cin in the treatment of malignant pleural effusion through intrapleural catheter

目的：观察胸腔内置管分别注入溶链菌制剂（沙培林）联合丝裂霉素与香菇多糖联合丝裂霉素治疗恶性胸腔积液的临床疗效及药物副反应。方法收集恶性胸腔积液患者70例，按随机数字表法将患者分成溶链菌制剂组和香菇多糖组。1例患者因青霉素阳性由溶链菌制剂组调整进入香菇多糖组。实际溶链菌制剂组34例，香菇多糖组36例。予置管引流干净胸腔积液后，注入溶链菌制剂＋丝裂霉素或香菇多糖＋丝裂霉素。记录不良反应，4周后评估疗效。结果溶链菌制剂组总有效率为85．3％，香菇多糖组总有效率为83．3％，差异无统计学意义（χ2＝0.051，P ＝0．822）。两组均有胸痛、发热、恶性、呕吐、外周血白细胞下降等副反应，均较轻微，未观察到肝肾功能损害。结论胸腔内注入溶链菌制剂联合丝裂霉素或香菇多糖联合丝裂霉素治疗恶性胸腔积液均可取得较好的临床效果，且副反应较小、安全性好。

Objective To explore the effect and side effects of Group A Streptococcus Preparation（Sapylin）com-bined with mitomycin and lentinan combined with mitomycin in treating malignant pleural effusion through intrapleural catheter.Methods 70 malignant pleural effusion patients were selected in this study.All the patients were randomly divided into Sapylin group and lentinan group.One case with penicillin positive of the Sapylin group was adjusted to enter the lentinan group.After drainage of pleural effusion,the patients were divided into Sapylin group （34 patients） and lentinan group （36 patients）.For the Sapylin group,Sapylin was prior injected and mitomycin was posterior injected.For the lentinan group,lentinan was prior injected and mitomycin was posterior injected.The side effects and clinical effect were observed and reported.Results The effective rate of Sapylin group was 85.3%,whereas 83.3%of lentinan group.There was no significant difference between the two groups（χ2 =0.051,P =0.822）.Both groups had the following minor side effects：chest pain,fever,vomit and decreased white blood cells.No liver or renal injuries were reported.Conclusion The clinical outcomes of Sapylin combined with mitomycin and lentinan combined with mitomycin are both positive,in addition,the side effects are minor.