奈达铂联合黄芪多糖序贯性胸腔内给药对肺癌恶性胸水治疗效果的临床观察

目的 观察奈达铂联合黄芪多糖序贯性胸腔内给药对肺癌恶性胸水的临床治疗效果.方法 确诊的肺癌胸腔积液患者90例,随机分为研究组和对照组,每组45例.研究组给予奈达铂+黄芪多糖序贯性胸腔给药,对照组给予奈达铂胸腔灌注.疗程结束3周时比较2组的治疗效果、生活质量、药物相关不良反应,检测2组患者T淋巴细胞亚群、免疫球蛋白及氧化应激指标PKM2的水平.结果 2组患者均按疗程完成治疗及检测.研究组的有效率明显高于对照组(P<0.05).患者生活质量以汉密顿焦虑量表(HAMA)、生活活动能力Barthel指数、视觉模拟评分量表(VAS)评价;2组治疗前HAMA、Barthel指数、VAS评分差异无统计学意义(P>0.05),治疗后HAMA、VAS评分均明显下降,而Barthel指数明显升高(P<0.05),治疗后研究组的各指标变化优于对照组(P<0.05).研究组患者药物相关不良反应发生率低于对照组(P<0.05).治疗前2组T淋巴细胞亚群、免疫球蛋白差异均无统计学意义(P>0.05).治疗后研究组PKM2下降,其他各项指标均高于治疗前(P<0.05);对照组仅IgG高于治疗前(P<0.05),CD+3、CD+4均明显降低(P<0.05),而CD+4/CD+8、IgM在治疗前后差异无统计学意义(P>0.05).治疗后研究组CD+4/CD+8与对照组差异无统计学意义(P>0.05),其他指标均高于对照组(P<0.05).结论 应用奈达铂联合黄芪多糖序贯性胸腔内给药治疗肺癌恶性胸腔积液的效果优于单纯应用奈达铂,可以有效改善患者的免疫应激状态,值得在临床推广应用.

Therapeutic effects of nedaplatin combined with Astragalus polysaccharide by consistent intrathoracic medication on malignant pleural effusion caused by lung cancer

Objective To observe the therapeutic effects of nedaplatin combined with Astragalus polysaccharide by consistent intrathoracic medication on malignant pleural effusion caused by lung cancer.Methods Ninety patients with malignant pleural effusion caused by lung cancer were randomly divided into research group and control group,with 45 patients in each group.The patients in research group were treated by nedaplatin combined with Astragalus polysaccharide by means of consistent intrathoracic medication, however, the patients in control group were treated by nedaplatin intraperitoneal perfusion only.The therapeutic effect,life quality of patients, drug related adverse reactions were observed for both groups,moreover,the levels of T lymphocyte subsets,immunoglobulins, PKM2 and SOD were detected and compared between two groups.Results After treatment,the effective rate in research group was significantly higher than that in control group (P<0.05).The life quality of patients was evaluated by HAMA,Barthel index and VAS scores,and there were no significant differences in HAMA,Barthel index,VAS scores before treatment between two groups (P>0.05),after treatment,HAMA and VAS scores were obviously decreased, however, Barthel indexes were significantly increased (P<0.05),moreover, the indexes including HAMA,Barthel index,VAS scores in research group were superior to those in control group (P<0.05).The incidence rates of drug related adverse reactions in research group were significantly lower than those in control group (P<0.05).Before treatment there were no significant differences in T lymphocyte subsets,immunoglobulins and PKM2 between 2 groups (P>0.05).After treatment,PKM2 in research group was obviously decreased (P<0.05), but the other indexes were significantly increased,as compared with those before treatment (P<0.05).However the levels of IgG in control group were higher than those before treatment,but the levels of CD+3 and CD+4 were significantly decreased,moreover there were no significant differences in CD+4/CD+8 and IgM before treatment and after treatment (P>0.05).After treatment there was no significant difference in CD+4/CD+8 between two groups (P>0.05),however,the other indexes in research group were significantly higher than those in control group (P<0.05).Conclusion The therapeutic effects of nedaplatin combined with Astragalus polysaccharide by means of consistent intrathoracic medication on malignant pleural effusion caused by lung cancer are superiorto those by nedaplatin medication only,which can effectively improve the immunity stress status of patients,therefor,which is worth using widely in clinical practice.