深部热疗联合腹腔灌注贝伐珠单抗治疗恶性腹腔积液的效果及对免疫功能的影响

Effect of Deep Thermal Therapy Combined with Abdominal Peritoneal Infusion of Bevacizumab in the Treatment of Malignant Peritoneal Fluid and the Influence on Immune Function

目的:探讨深部热疗联合腹腔灌注贝伐珠单抗治疗恶性腹腔积液的效果及对免疫功能的影响。方法:选取2020年1月4日-2022年12月4日上海杨思医院收治的恶性腹腔积液患者98例为研究对象。随机分为新式组、传统组,各49例。传统组使用腹腔灌注贝伐珠单抗治疗,新式组在传统组基础上应用深部热疗。比较两组近期疗效、腹腔积液内血管内皮生长因子(VEGF)表达情况和外周血免疫功能指标。结果:新式组疾病控制率高于传统组,差异有统计学意义(P<0.001)。治疗前,两组VEGF、CD4^(+)CD25^(+)调节T细胞(CD4^(+)CD25^(+)T)、细胞毒性T淋巴细胞(CTL)、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05);治疗后,两组VEGF、CD4^(+)CD25^(+)T、CD8^(+)水平降低,CTL、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平升高,新式组VEGF、CD4^(+)CD25^(+)T、CD8^(+)水平低于传统组,CTL、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于传统组,差异有统计学意义(P<0.05)。结论:深部热疗联合腹腔灌注贝伐珠单抗治疗恶性腹腔积液效果较好,可降低VEGF水平,增强免疫功能。

Objective:To investigate the effect of deep thermal therapy combined with abdominal peritoneal infusion of bevaci-zumab in the treatment of malignant peritoneal fluid and the effect on immune function.Methods:Ninety-eight patients with ma-lignant peritoneal effusion admitted to Shanghai Yangsi Hospital from January 4,2020 to December 4,2022 were selected as study subjects.They were randomly divided into new style group and traditional group,each with forty-nine cases.The tradition-al group was treated with abdominal peritoneal infusion of bevacizumab,and the new style group applied deep thermal therapy on the basis of the traditional group.The two groups were compared in terms of recent efficacy,expression of vascular endotheli-al growth factor(VEGF)in the peritoneal fluid and peripheral blood immune function indexes.Results:The disease control rate of the new style group was higher than that of the traditional group,and the difference was statistically significant(P<0.001).Be-fore treatment,the levels of VEGF,CD4^(+)CD25^(+)regulatory T-cells(CD4^(+)CD25^(+)T),cytotoxic T-lymphocytes(CTL),CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the two groups were compared with each other,and the difference was statistically not significant(P>0.05);after treatment,the levels of VEGF,CD4^(+)CD25^(+)T,and CD8^(+)decreased and the levels of CTL,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in-creased in the two groups;the levels of VEGF,CD4^(+)CD25^(+)T,and CD8^(+)in the new style group were lower than those in the tradi-tional group,and the levels of CTL,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were higher than those in the traditional group,with a statisti-cally significant difference(P<0.05).Conclusion:Deep thermal therapy combined with abdominal peritoneal infusion of bevaci-zumab is more effective in the treatment of malignant peritoneal fluid,which can reduce the level of VEGF and enhance the im-mune function.