胸腔引流联合免疫疗法治疗老年肺癌患者胸腔积液的疗效观察

目的:分析胸腔引流联合免疫疗法治疗老年肺癌合并胸腔积液患者的临床疗效及对VEGF和AQP1水平的影响。方法:将我院2017年04月至2019年04月间收治的100例老年肺癌胸腔积液患者随机分为A组、B组及C组;A组患者采用胸腔引流术治疗，B组患者采用免疫疗法治疗，C组患者采用胸腔引流联合免疫疗法治疗;治疗后参照WHO对患者的癌性渗液治疗的近期疗效进行评估;治疗前及治疗后4周采用Karnofsky评分标准对患者生活质量进行评估;治疗前及治疗后采集患者胸腔积液检测其中CEA、CYFRA21-1、NSE、VEGF和AQP1水平。结果:经治疗后C组患者治疗总有效率及生活质量均明显好于A组及B组，且差异均有统计学意义（P＜0.05）;治疗后C组患者胸腔积液中CEA、NSE及CYFRA21-1水平明显低于A组及B组，且差异有统计学意义（P<0.05）;治疗后C组患者胸腔积液中VEGF及AQP1水平明显低于A组及B组，且差异有统计学意义（P<0.05），B组患者胸腔积液中VEGF水平显著低于A组（P＜0.05），但A组与B组患者胸腔积液中AQP1水平无明显差异（P＞0.05）。结论:采用胸腔引流联合免疫疗法治疗老年肺癌患者胸腔积液可显著提高患者治疗疗效及生活质量，并可有效降低胸腔积液中VEGF和AQP1蛋白表达。

Effects of thoracic drainage combined with immunotherapy on pleural effusion in elderly patients with lung cancer

Objective:To analyze the clinical efficacy of thoracic drainage combined with immunotherapy in the treatment of elderly lung cancer patients with pleural effusion and the method of influencing the levels of vascular endothelial growth factor and AQP1.Methods:From April 2017 to April 2019,100 elderly patients with pleural effusion from lung cancer were randomly divided into group A,group B and group C.Patients in group A were treated with thoracic drainage.Patients in group B were treated with immunotherapy,and patients in group C were treated with thoracic drainage combined with immunotherapy.Karnofsky score was used to evaluate the quality of life of patients before and 4 weeks after treatment.The levels of CEA,CYFRA21-1,NSE,VEGF and AQP1 were measured before and after treatment.Results:After treatment,the total effective rate and quality of life in group C were significantly higher than those in group A and group B,and the difference was statistically significant (P＜0.05).After treatment,the levels of CEA,NSE and CYFRA21-1 in pleural effusion in group C were significantly lower than those in group A and group B,and the difference was statistically significant (P＜0.05).After treatment,the levels of VEGF and AQP1 in pleural effusion in group C were lower than those in group A and group B,and the difference was statistically significant (P＜0.05).The level of vascular endothelial growth factor in pleural effusion in group B was significantly lower than that in group A (P＜0.05),but the level of AQP1 in pleural effusion in group A and group B had no significant difference (P＞0.05).Conclusion:Thoracic drainage combined with immunotherapy can significantly improve the therapeutic efficacy and quality of life of elderly patients with pleural effusion of lung cancer,and effectively reduce the expression of vascular endothelial growth factor and AQP1 protein in pleural effusion.