沙培林联合顺铂对肺癌伴恶性胸腔积液的疗效分析

Analysis on efficacy of Sapylin combined with Cisplatin in treatment of lung cancer with malignant pleural effusion

目的探讨沙培林联合顺铂对肺癌伴恶性胸腔积液的临床疗效及对各细胞因子水平的影响。方法回顾性分析2017年2月~2018年5月经病理明确诊断为肺癌伴恶性胸腔积液患者共100例,分为对照组(50例)和观察组(50例)。对照组予以充分引流胸腔积液后行胸腔灌注顺铂注射液,观察组在对照组基础上加用沙培林胸腔灌注治疗,比较两组临床疗效、血清炎性因子白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)及胸腔积液的癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19的可溶性片段(CYFRA21-1)水平。结果观察组近期疗效(98.00%)高于对照组(86.00%)(P<0.05);观察组与治疗组治疗后IL-6、TNF-a及IL-8水平低于治疗前(P<0.05);治疗后观察组血清IL-6、IL-8、TNF-α水平均低于对照组(P<0.05);治疗后两组患者CEA、NSE、CYFRA21-1水平均低于治疗前(P<0.05);治疗后观察组CEA、NSE、CYFRA21-1水平低于对照组(P<0.05)。结论顺铂联合沙培林治疗恶性胸腔积液,可获得较好的近期临床疗效,能降低血清中细胞炎症因子及胸腔积液肿瘤标志水平,并减轻顺铂单药灌注化疗毒性,达到更优疗效。

Objective To explore the clinical efficacy of the combination of Sapylin(Streptococcus A Group for Injection)and Cisplatin in treatment of lung cancer with malignant pleural effusion(MPE)and its effect on levels of cytokines.Methods A total of 100 patients pathologically diagnosed with lung cancer with MPE in our hospital from February 2017 to May 2018 were retrospectively analyzed and divided into a control group(n=50)and an observation group(n=50).Intrapleural infusion of Cisplatin Injection was performed for both the control group and the observation group after full drainage of pleural effusion.In addition,the observation group received intrapleural infusion of Sapylin.A comparison was made between the two groups in terms of clinical efficacy,levels of serum inflammatory cytokines[interleukin-6(IL-6),interleukin-8(IL-8)],tumor necrosis factorα(TNF-α),carcinoembryonic antigen(CEA)of pleural effusion,neuron specific enolase(NSE)and soluble fragment of cytokeratin 19(CYFRA21-1).Results The short-term efficacy rate of the observation group was higher than that of the control group(98.00%vs86.00%,P<0.05).After the treatment,the levels of IL-6,TNF-αand IL-8 in both the observation group and the control group were lower than that before the treatment(P<0.05).The levels of serum IL-6,IL-8 and TNF-αin the observation group after the treatment were lower than that in the control group(P<0.05).After the treatment,the levels of CEA,NSE,and CYFRA21-1 in both groups were lower than that before the treatment(P<0.05).The levels of CEA,NSE,and CYFRA21-1 in the observation group were lower than that in the control group(P<0.05).Conclusion Application of Cisplatin combined with Sapylin in treatment of MPE can produce higher short-term efficacy,reduce the levels of serum inflammatory cytokines and tumor markers of pleural effusion,and attenuate the adverse toxicity caused by infusion chemotherapy of Cisplatin alone,so as to achieve better efficacy.