袁胜芳,
王布,
项保利,
赵建清,
张志华^,,
张秀珑
河北北方学院附属第一医院 呼吸与危重症医学科，河北 张家口 075000

基金项目: 河北省科技计划项目（20377717D）；河北省卫健委课题（20200525）


详细信息 作者简介: 袁胜芳（1990-），女，主治医师。E-mail：YSF1252877168@163.com






通讯作者: 张志华，主任医师。E-mail：15530330015@163.com 中图分类号: R561.3


摘要:目的探讨贝伐珠单抗联合洛铂胸腔内注射治疗肺癌所致恶性胸腔积液（MPE）的临床效果。方法收集河北北方学院附属第一医院2020年1月至2021年1月收治的78例肺癌致MPE患者临床资料，其中贝伐珠单抗联合洛铂胸腔内注射治疗患者43例为试验组，洛铂胸腔内注射治疗患者35例为对照组。比较两组的临床疗效、治疗前后血管内皮生长因子（VEGF）、HIF-1α水平、外周血中CD3⁺、CD4⁺及CD4⁺/CD8⁺水平、HAM-A、HAM-D评分、不良反应及预后情况。结果试验组总治愈率（83.72%）高于对照组（51.43%）（P＜0.05）。治疗后试验组胸腔积液中VEGF、HIF-1α水平分别为（411.03±18.45）ng/mL、（38.18±2.42）ng/mL，低于对照组（528.79±29.20）ng/mL和（49.50±4.08）ng/mL（P＜0.05）；外周血中CD3⁺、CD4⁺、CD4⁺/CD8⁺分别为（69.45±4.87）%、（39.25±5.22）%和1.88±0.18，高于对照组（65.03±7.27）%、（34.88±7.90）%和1.41±0.38（P＜0.05）。治疗后试验组HAM-A、HAM-D评分分别为17.42±2.66和14.26±5.93，低于对照组21.09±4.14和16.83±5.93（P＜0.05）。试验组中位无进展生存期7.6个月，较对照组（5.1个月）延长（P＜0.05）；两组间不良反应发生率差异无统计学意义（P＞0.05）。结论贝伐珠单抗联合洛铂胸腔内注射治疗肺癌所致的MPE有效且安全。
关键词: 贝伐珠单抗/
洛铂/
肺癌/
恶性胸腔积液/
胸腔灌注


Abstract:ObjectiveTo investigate the clinical effect of bevacizumab combined with lobaplatin in the treatment of malignant pleural effusion caused by lung cancer.MethodsTotally, 78 patients with malignant pleural effusion of lung cancer admitted to our hospital from January 2020 to January 2021 were enrolled in the study. Among them, 43 patients (experimental group) were treated with intrapleural injection of bevacizumab combined with lobaplatin and 35 patients (control group) were treated with intrapleural injection of lobaplatin. To compare the clinical efficacy, vascular endothelial growth factor (VEGF) and HIF-1α levels, improvement of immune function, HAM-A, HAM-D scores, adverse reactions, and prognosis before and after treatment were analyzed in the two groups.ResultsThe total cure rate of the experimental group (83.72%) was higher than that of the control group (51.43%) (P＜0.05). After treatment, the levels of VEGF and HIF-1α in the pleural effusion of the experimental group were (411.03±18.45) ng/mL and (38.18±2.42) ng/mL, lower than (528.79±29.20) ng/mL and (49.50±4.08) ng/mL in the control group (P＜0.05). The levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the peripheral blood were (69.45±4.87)%, (39.25±5.22)%, and 1.88±0.18, higher than (65.03±7.27)%、(34.88±7.90)% and 1.41±0.38 in the control group (P＜0.05). After treatment, the HAM-A and HAM-D scores in the experimental group were 17.42±2.66 and 14.26±5.93, lower than 21.09±4.14 and 16.83±5.93 in the control group (P＜0.05). The median progression free survival period in the experimental group was 7.6 months, longer than 5.1 months in the control group (P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P＞0.05).ConclusionIntrapleural injection of bevacizumab combined with lobaplatin is effective and safe in the treatment of malignant pleural effusion caused by lung cancer.
Keywords:bevacizumab/
lobaplatin/
lung cancer/
malignant pleural effusion/
thoracic perfusion

PDF全文下载地址:

https://journal.dmu.edu.cn/data/article/export-pdf?id=65090e81fa89b2fe327f3301