顺铂联合甘露聚糖肽与联合OK-432胸腔注射治疗恶性胸腔积液的临床分析

[目的]对比观察中心静脉导管胸腔引流并顺铂联合甘露聚糖肽（多抗）或OK-432（沙培林）治疗恶性胸腔积液的临床疗效和毒副反应。[方法]99例恶性胸腔积液病人，随机分为2组：甘露聚糖肽组（A组）53例，OK432组（B组）46例。行中心静脉导管胸腔引流术，A组胸腔注射甘露聚糖肽和顺铂，B组胸腔注射0K432和顺铂。两组均每周重复，连续2～4周。[结果]A组RR43例（81．1％）。B组RR39例（84．8％），两组有效率无统计学差异（P=0．631）。A组有3例（5．7％）病人发热，B组有24例（52．2％）病人发热（P〈0．001）。[结论]中心静脉导管胸腔引流并顺铂联合甘露聚糖肽或OK432治疗恶性胸腔积液均较安全且方便，临床疗效相似，但沙培林组发热的发生率远高于甘露聚糖肽组。

Clinical Comparative Analysis of Cisplatin Combined with Mannatide and with OK-432 in Intrapleural Therapy for Malignant Pleural Effusion

[Purpose ] To compare the efficacy and toxicity of cisplatin combined with mannatide and with OK-432 by central venous catheter in the treatment of malignant pleural effusion. [Methods ] A total of 99 cases with malignant pleural cavity effusion were randomly divided into two groups： mannatide group （group A） 53 cases and OK-432 group （group B） 46 cases. All patients underwent pleural central venous catheter drainage： group A received mannatide plus cisplatin intrapleuraly; group B received OK-432 plus cisplatin intrapleurally. Treatment for both groups were repeated every week and continued for two to four weeks. [Results] The response rates （RR） were 81.1% （43 cases） in group A and 84.8% （39 cases） in group B. There was no difference in RR between the two groups（P=0.631）. Three cases （5.7%） had a fever in group A and 24 cases（52.2%） in group B （P〈0.001）. [Conclusion] Cisplatin combined with mannatide or OK-432 by central venous catheter in the intrapleural therapy for malignant pleural effusion is well-tolerated and convenience with similar RR. The febrile morbidity in OK-432 group（group B） is significantly higher than that in mannatide group（group A）.