恩度联合顺铂局部治疗恶性胸腔积液的临床研究-内科学(肿瘤内科)专业论文.docxVIP

重组人血管内皮抑制素（恩度）联合顺铂局部治疗恶性胸腔 积液的临床研究 中文摘要 目的 观察重组人血管内皮抑制素联合顺铂行胸腔灌注治疗恶性胸腔积液的近 期疗效及安全性分析。 方法 2011 年 1 月至 2011 年 12 月间青海大学附属医院 60 例恶性胸腔积液病人 随机分为治疗组和对照组。治疗组予重组人血管内皮抑制素（恩度） 30mg+顺铂 60mg/m2+生理盐水 200ml 胸腔内注射。对照组采用顺铂 60mg/㎡ +生理盐水 200ml 胸腔内灌注。1 个月为 1 个疗程，于 D1，D8、各腔内注药 1 次，共二次。为使药 物充分与胸膜腔广泛接触，胸腔注药后嘱患者每 15 分钟变换体位一次。治疗后 一个月来我院行超声检查，并对患者再次进行 Karnofsky 功能状态评分。并行近 期疗效评价和观察不良反应。胸腔灌注治疗前及治疗后采用 ELISA 法测定胸水 VEGF 水平。 结果 全组 60 例患者均完成了 1 个疗程的治疗。30 例治疗组近期临床疗效有效 率（RR）为 76.67%。30 例对照组 RR 为 43.8%。两组相比差异有统计学意义 (P0.05)。治疗前两组胸水 VEGF 水平比较差异无统计学意义(P0.05)。治疗后 两组胸水 VEGF 水平显著下降。与治疗前比较差异均有统计学意义(P0.05)。治 疗后两组胸水 VEGF 水平比较差异有统计学意义(P0.05)。两组均有发热、恶心 呕吐、外周白细胞减少等不良反应，但差异均无显著性。 结论 重组人血管内皮抑制素（恩度）联合顺铂胸腔灌注治疗恶性胸胸腔积液 近期疗效明显,毒副反应轻, 经治疗后治疗组胸腔积液 VEGF 水平下降明显，并 通过抑制 VEGF 的表达来达到抑制肿瘤生长和转移。 关键词 恶性胸腔积液；重组人血管内皮抑制素；顺铂；VEGF Recombinant Human Endostatin Combined with Cisplatin for Malignant Pleural Effusion：A Clinical Study Abstract Objective To evaluate the short-term curative efficacy and safety of recombinant human endostatin plus cisplatin(thoracic cavity perfusion)formalignant pleural effusion. Methods 60 cases of patients with malignant pleural effusion were randomly divided into treatment group and control group. The control group was treated with DDP pleural perfusion, and the treatment group was treated with DDP combined endostar by sequential pleural perfusion. 1 month after treat ment the clinical efficacy and toxicity were evaluated. Before and after therapy by pleural perfus ion the VEGF levels in pleural effusion detected by ELISA method . Results After therapy, the VEGF levels in pleural effusion were significantly decreased, compared with prior-treatment the difference was significant ( P0.05), All patients completed the therapy of 1 cycles, the short-termclinical efficacy rate of the treatment group was 76.67%, the control group was 43.8%, compared the different was significant (P0.05).The adverse effect such as fever、nausea vomit and leukopenia ocurred in both group，but there no significant difference in two g