贝伐单抗靶向治疗重度脑水肿临床研究及评估

Clinical study and evaluation of bevacizumab targeted treatment in severe brain edema

目的探讨贝伐单抗靶向治疗重度脑水肿的临床应用及价值评估。方法对广东省医科大学附属南山医院自2014年3月至2016年1月收治的29例重度脑水肿患者应用贝伐单抗靶向治疗。采用动态头部MRI、格拉斯哥（GCS）评分评估治疗后3周疗效,采用改良Rankin量表评估治疗后6个月患者的生活质量。结果贝伐单抗可明显逆转脑水肿损害。用药1周开始显效,2-3周持续起效。治疗后3周脑水肿程度明显减轻,水肿范围明显缩小,GCS评分明显升高,与治疗前比较,差异有统计学意义（P〈0.01）。治疗后6个月改良Rankin量表评分明显下降,与治疗前比较,差异有统计学意义（P〈0.01）。结论贝伐单抗靶向治疗可以明显消退脑水肿、逆转病损、改善总体临床预后。

Objective To explore and evaluate bevacizumab targeted treatment in severe cerebral edema. Methods A retrospective study was performed on 29 patients with severe cerebral edema underwent bevacizumab targeted therapy in Nanshan Hospital of Guangdong Medical University from March 2014 to January 2016. The dynamic head MRI and Glass Coma Scale（ GCS） score were used to evaluate patients 3 weeks after surgery,the subsequently modified Rankin scale was used to evaluate the quality of life of patients 6months after treatment. Results Bevacizumab reversed the brain edema damage,general markedly effective time at the first week after treatment,in 2-3 weeks sustained significant effect. The degree of cerebral edema was significantly reduced 3 weeks after treatment,the range of edema was significantly reduced,GCS score was significantly higher than pre-treatment,and the modified Rankin scale score reduced significantly compared with pre-treatment,all of which had statistical significance（ P 〈0. 01）. Conclusion Preliminary evaluation of bevacizumab targeted treatment in severe cerebral edema can significantly promote the brain edema subsided,reverse lesion and improve overall clinical outcome.