重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效观察

Clinical Effect of Pleural Perfusion of Human Recombinant Endostatin Injection Combined With Cisplatin Injection on Advanced Non-small Cell Lung Cancer Complicated With Malignant Pleural Effusion

目的观察重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效。方法选取2011—2014年陕西省人民医院收治的晚期非小细胞肺癌恶性胸腔积液患者90例,随机分为对照组与治疗组,每组45例。对照组患者予以顺铂注射液胸腔灌注治疗,治疗组患者予以重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗;两组患者均连续治疗3周。比较两组患者临床疗效、生活质量、治疗前后免疫功能指标〔自然杀伤(NK)细胞分数、T细胞亚群(CD^+_3细胞分数、CD^+_4细胞分数、CD^+_8细胞分数及CD^+_4/CD^+_8细胞比值)〕及毒副作用发生情况。结果治疗组患者临床疗效优于对照组(P<0.05)。治疗组患者生活质量优于对照组(P<0.05)。治疗前两组患者NK细胞分数、CD^+_3细胞分数、CD^+_4细胞分数、CD^+_8细胞分数及CD^+_4/CD^+_8细胞比值比较,差异无统计学意义(P>0.05);治疗后治疗组患者NK细胞分数、CD^+_3细胞分数、CD^+_4细胞分数及CD^+_4/CD^+_8细胞比值高于对照组,CD^+_8细胞分数低于对照组(P<0.05)。两组患者发热、恶心呕吐、乏力、白细胞和/或血小板计数减少发生率比较,差异无统计学意义(P>0.05)。结论重组人血管内皮抑制素注射液联合顺铂注射液胸腔灌注治疗晚期非小细胞肺癌恶性胸腔积液的临床疗效确切,可有效改善患者的生活质量,增强患者的免疫功能,且安全性高。

Objective To observe the clinical effect of pleural perfusion of human recombinant endostatin injection combined with cisplatin injection on advanced non- small cell lung cancer complicated with malignant pleural effusion. Methods A total of 90 advanced non- small cell lung cancer patients complicated with malignant pleural effusion were selected in the People’s Hospital of Shaanxi Province from 2011 to 2014,and they were randomly divided into control group and treatment group,each of 45 cases. Patients of control group received pleural perfusion of cisplatin injection, while patients of treatment group received pleural perfusion of human recombinant endostatin injection combined with cisplatin injection; both groups continuously treated for 3 weeks. Clinical effect,quality of life,index of immunological function（ including NK cell percentage,CD+3 cell percentage,CD+4 cell percentage,CD+8 cell percentage and CD+4/ CD+8 cell ratio） before and after treatment,and incidence of toxic and side effects were compared between the two groups. Results The clinical effect and quality of life of treatment group was statistically significantly better than that of control group,respectively（ P < 0. 05）. No statistically significant differences of NK cell percentage, CD+3 cell percentage, CD+4 cell percentage, CD+8 cell percentage or CD+4/ CD+8 cell ratio was found between the two groups before treatment（ P > 0. 05）; after treatment, NK cell percentage, CD+3 cell percentage, CD+4 cell percentage and CD+4/CD+8 cell ratio of treatment group were statistically significantly higher than those of control group,while CD+8 cell percentage of treatment group was statistically significantly lower than that of control group（ P < 0. 05）. No statistically significant differences of pyrexia,nausea or vomiting,lacking in strength,white blood cell count decrease or blood platelet count decrease was found between the two groups（ P > 0. 05）. Conclusion Pleural perfusion of human recombinant endostatin injection combined with cisplatin injection has certain clinical effect in treating advanced non- small cell lung cancer complicated with malignant pleural effusion,can effectively improve the quality of life and immunologic function,and is safe.