重组改构人肿瘤坏死因子联合博来霉素胸腔灌注治疗肺癌恶性胸腔积液的临床观察

目的　观察重组改构人肿瘤坏死因子（ｒｈｍＴＮＦ）联合博来霉素（ＢＬＭ）胸腔灌注治疗肺癌恶性胸腔积液的近期疗效及毒副反应。方法　收集２００７年６月至２０１０年１０月１１２例肺癌伴恶性胸腔积液患者，经胸腔置中心静脉导管排尽胸腔积液后分为３组。ｒｈｍＴＮＦ组３２例胸腔内灌注ｒｈｍＴＮＦ２００万～３００万单位，ＢＬＭ组４１例胸腔内灌注ＢＬＭ４０～６０ｍｇ，联合组３９例胸腔内联合灌注ｒｈｍＴＮＦ２００万～３００万单位和ＢＬＭ４０～６０ｍｇ。３组患者均每周治疗２次，共４次。治疗后１个月观察近期疗效、毒副反应及ＫＰＳ评分改善情况。结果　ｒｈｍＴＮＦ组、ＢＬＭ组和联合组的有效率分别为４６.９％、４６.３％和８２.１％，联合组显著高于其他两组（Ｐ＜０.０５）。３组主要毒副反应为发热及胸痛，３组间差异无统计学意义（Ｐ＞０.０５）。ｒｈｍＴＮＦ组、ＢＬＭ组和联合组ＫＰＳ评分改善率分别为５３.１％、５１.２％和８４.６％，联合组显著高于其他两组，差异有统计学意义（Ｐ＜０.０５）。结论　ｒｈｍＴＮＦ联合ＢＬＭ胸腔灌注治疗肺癌恶性胸腔积液有效、安全，值得推广。

Clinical observation of rmhTNF combined with bleomycin on patients with malignant pleural effusion caused by lung cancer

Objective To observe the efficacy and toxicity of recombinant mutant human tumor necrosis factor(rmhTNF) and bleomycin(BLM) on patients with malignant pleurisy effusion caused by lung cancer. Methods One hundred and twelve patients with malignant pleural effusion caused by lung cancer enrolled from June 2007 to October 2010 were divided into three groups.Group rmhTNF was intra-pleurally infused with 2-3 million units of rmhTNF.Group BLM was infused with 40-60mg of BLM.Group rmhTNF+BLM was infused with 2-3 m...