甘露聚糖肽联合斑蝥酸钠维生素B6治疗恶性胸腔积液的临床研究

Clinical study on mannatide combined with vitamin sodium and vitamin B6 in treatment of malignant pleural effusion

目的探讨甘露聚糖肽联合斑蝥酸钠维生素B6治疗恶性胸腔积液的临床疗效。方法收集2016年1月—2017年1月在溧阳市人民医院进行治疗的恶性胸腔积液患者78例,根据用药的差别分为对照组(39例)和治疗组(39例)。对照组胸腔注入斑蝥酸钠维生素B6注射液,50 m L加入20 m L生理盐水,1次/周;治疗组在对照组的基础上胸腔注入甘露聚糖肽注射液,80 m L加入20 m L生理盐水,1次/周。两组患者均经过4周治疗。评价两组患者临床疗效,同时比较治疗前后两组患者胸水指标和KPS评分变化。结果治疗后,对照组和治疗组的临床总有效率分别为64.10%和84.62%。两组比较差异具有统计学意义(P<0.05)。治疗后,两组癌胚抗原(CEA)、胰岛素样生长因子结合蛋白-2(IGFBP-2)、基质金属蛋白酶-9(MMP-9)水平均显著降低,干扰素-γ(IFN-γ)和白细胞介素-2(IL-2)水平显著增高,同组比较差异具有统计学意义(P<0.05);且治疗组上述指标水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组KPS评分均升高(P<0.05);且治疗组患者比对照组升高更明显(P<0.05)。结论甘露聚糖肽联合斑蝥酸钠维生素B6治疗恶性胸腔积液可有效降低癌胚抗原水平,增强机体免疫功能,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of mannatide combined with vitamin sodium and vitamin B6 in treatment of malignant pleural effusion. Methods Patients （78 cases） with malignant pleural effusion in Liyang City People＇s Hospital from January 2016 to January 2017 were divided into control （39 cases） and treatment （39 cases） groups according to different treatments. Patients in the control group were intrapleural injection administered with Disodium Cantharidinate and Vitamin B6 Injection, 50 mL added into normal saline 20 mL, once weekly. Patients in the treatment group were intrapleural injection administered with Mannatide Injection on the basis of the control group, 80 mL added into normal saline 20 mL, once weekly. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the change of pleural fluid indexes and KPS scores in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 64.10% and 84.62%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, the CEA, IGFBP-2 and MMP-9 levels in two groups were significantly decreased, IFN-γ and IL-2 levels were significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And these indexes levels in the treatment group were obviously better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the KPS score in two groups was significantly increased （P 〈 0.05）. And the KPS score in the treatment group increased more obviously than that in the control group （P 〈0.05）. Conclusion Mannatide combined with vitamin sodium and vitamin B6 can reduce carcinoembryonic antigen levels and enhance immune function in treatment of malignant pleural effusion, which has a certain clinical application value.