新型重组人肿瘤坏死因子治疗恶性腹水的临床研究

新型重组人肿瘤坏死因子（ｒｈ－ＴＮＦ）系经基因重组、结构改建的肿瘤坏死因子。本研究旨在探讨ｒｈ－ＴＮＦ和化疗药５－氟尿嘧啶（５－ＦＵ）和丝裂霉素（Ｍｉｔｏｍｙｃｉｎ，ＭＭＣ）对恶性腹水的治疗效果，６４例恶性腹水分三组进行：Ｔ组（ＴＮＦ）２１例，ＦＭ组（５－ＦＵ，ＭＭＣ）１８例，ＴＦＭ组（ＴＮＦ，５－ＦＵ，ＭＭＣ）２５例。结果显示治疗恶性腹水的有效率分别为ＴＦＭ组９２．３％、Ｔ组８５．７％、ＦＭ组５０．０％。ＴＦＭ和Ｔ组较ＦＭ组疗效相差显著（Ｐ＜０．０１），ＴＦＭ和Ｔ组相差不显著（Ｐ＞０．０５），Ｔ组和ＴＦＭ组未见明显副作用。三组产生疗效的平均时间分别为ＴＦＭ组７．２ｄ、Ｔ组１１．５ｄ、ＦＭ组１８．２ｄ。表明ｒｈ－ＴＮＦ治疗恶性腹水具有疗效高，副作用小等优点。ｒｈ－ＴＮＦ和化疗药ＦＭ合用，可减少ＴＮＦ用量，缩短疗程，是治疗恶性腹水的理想方法。

Clinical Study on Treatment of Malignant Ascites withNovel Recombinant Human Tumor Necrosis Factor

Novel recombinant human tumor necrosis factor(rh-TNF) was reconstructed by genetic engi-neering.In order to investigated the effect of intraperitoneal administration of rh-TNF and chemotherapydrugs(5-FU,MMC) in the treatment of malignant ascites,64 patients with refractory malignant ascites weredivided into 3 groups. The effective rate of patients responed with a complete or partial resolution of their as-cites was 92.3%(23/25)in TFM group,85.7%(18/21) in T group,and 50%(9/18)in FM group. There wasa significant difference in the treatment effect between FM and TFM or T group(P<0.01),but the differencebetween TFM and T group was not significant (P> 0.05).The rh-TNF related sider-effects were mild.Themean courses of treatment was 7.2d in TFM,11. 5d in T,and 18.2d in FM group.The results indicated thatrh-TNF was strongly effective in the treatment of malignant ascites. The combination of 5-FU and MMC withrh-TNF would decrease the dose of rh-TNF andreduce the treatement course.