不同剂量rmh TNF治疗晚期肿瘤恶性胸腔积液患者的疗效观察

Clinical observation of different doses of rmh TNF in the treatment of malignant pleural effusion of advanced stage

目的观察不同剂量重组改构人肿瘤坏死因子(rmh TNF)治疗晚期肿瘤恶性胸腔积液患者的临床效果。方法选取医院肿瘤科收治的晚期肿瘤恶性胸腔积液患者60例,随机分为观察组和对照组,每组30例。对照组给予200万IU、观察组给予300万IU rmh TNF胸腔灌注治疗,比较2组临床疗效、生活质量改善情况、不良反应发生情况。结果观察组近期总有效率为90. 00%,高于对照组的66. 67%(P <0. 05);治疗结束1个月后,2组精神好转、食欲增加、体力增加、体质量增加方面比较差异无统计学意义(P> 0. 05);在睡眠改善、KPS评分提高方面比较,2组差异有统计学意义(P <0. 05); 2组不良反应发生情况比较差异无统计学意义(P> 0. 05)。结论 300万IU rmh TNF胸腔灌注治疗晚期肿瘤恶性胸腔积液的近期疗效优于200万IU,可改善患者的生活质量,而未增加药物的不良反应。

Objective To observe the clinical effect of different doses of rmh TNF in the treatment of malignant pleural effusion of advanced stage. Methods Sixty patients with advanced malignant pleural effusion were randomly divided into observation group and control group,30 cases in each group. The control group received 2 × 10^6 IU rmh TNF chest perfusion,while the observation group received 3 × 10^6 IU. The therapeutic effects,improvement of quality of life and incidence of adverse reactions were compared between the 2 groups. Results The total effective rate in the observation group was 90. 00%,which was higher than 66. 67% in the control group（ P〈 0. 05）. One month after treatment,there was no significant difference in mental,appetite,physical strength and body mass between the two groups（ P〉 0. 05）. There was a significant difference in the improvement of sleep and the improvement of KPS score between the 2 groups（ P〈 0. 05）. There was no significant difference in the incidence of adverse reactions between the 2 groups（ P〉 0. 05）. Conclusion Using rmh TNF to treat advanced malignant pleural effusion,the short-term efficacy of 3 × 10^6 IU dosage is better than that of 2 × 10^6 IU dosage,which can improve the quality of life of patients without increasing the risk of adverse reactions.