顺铂、恩度序贯灌注治疗恶性胸腹水的临床疗效及其对血管内皮生长因子的影响

目的观察顺铂（DDP）、恩度序贯灌注治疗恶性胸腹水的临床疗效,探讨其对血管内皮生长因子（VEGF）的影响。方法 50例恶性胸腹水患者随机分为治疗组和对照组。对照组采用顺铂腹腔灌注治疗,治疗组采用顺铂、恩度序贯灌注治疗。每4周1次,1次为1周期,治疗2周期后评价临床疗效和毒副反应,胸腹腔灌注治疗前及治疗后第3 d和第7 d采用ELISA法测定胸腹水和血清VEGF水平。结果治疗后3 d,两组胸腹水和血清VEGF水平显著下降,与治疗前比较差异有统计学意义（P〈0.05）,但两组比较差异无统计学意义（P〉0.05）;治疗后7 d,治疗组胸腹水和血清VEGF水平显著下降,与治疗后3 d和对照组比较差异有统计学意义（P〈0.05）,而对照组与治疗后3 d比较差异无统计学意义（P〉0.05）。所有患者均完成了1~2个周期的治疗,治疗组近期临床疗效有效率为64.0%,高于对照组（40.0%）,两组相比较差异有统计学意义（P〈0.05）。两组毒副反应轻,患者可耐受。结论顺铂、恩度序贯灌注治疗恶性胸腹水近期疗效明显,毒副反应轻,并通过抑制VEGF的表达来达到抑制肿瘤生长和转移。

Clinical Efficacy of DDP Combined Endostar by Seguential Perfusion and Effect on VEGF Expression in Malignant Ascite/pleural Effusion

Objective To observe the clinical efficacy of DDP combined endostar by sequential ascite/pleural perfusion and effect on vascular endothelial growth factor(VEGF) expression in malignant ascite/pleural effusion.Methods 50 cases of patients with malignant ascite/pleural effusion were randomly divided into treatment group and control group.The control group was treated with DDP ascite/pleural perfusion,and the treatment group was treated with DDP combined endostar by sequential ascite/pleural perfusion.The treatment was once every 4 weeks,one treatment was 1 cycle,1-2 cycles after treatment the clinical efficacy and toxicity were evaluated.Before and after therapy by ascite/pleural perfusion the VEGF levels in ascite/pleural effusion and serum were detected by ELISA method in 3d and 7d.Results 3d after therapy,the VEGF levels in ascite/pleural effusion and serum were significantly decreased,compared with prior-treatment the difference was significant(P<0.05),but there was no significant difference between the two groups(P> 0.05);7d after therapy,the VEGF in ascite/pleural effusion and serum were significantly decreased,compared with the level of 3d after therapy and control group the difference was significant(P<0.05),but there was no significant difference the level of 3d after therapy in control group(P>0.05).All patients completed the therapy of 2 cycles,the short-term clinical efficacy rate of the treatment group was 64.0%,the control group was 40.0%,compared the different was significant(P<0.05).There was mild toxicity in the two groups,the patient can tolerate.Conclusion DDP combined endostar by sequential ascite/pleural perfusion has obvious curative effect,light toxicity.The program of therapy can inhibit tumor growth and metastasis by inhibiting the expression of VEGF.