CAJ | 학술논문

　　目的报告1例重组改构人肿瘤坏死因子-α(rmhTNF-α)治疗老年恶性胸、腹腔积液的临床病例。方法2010年我科收治1例肺癌并胸腹腔积液患者，给予留置胸腔和腹腔引流管，每天放尽胸、腹水并记录引流量后，分别注入地塞米松磷酸钠注射液2 mg、5 mg，然后分别将rmhTNF-α200万U、500万U溶于20 ml 0.9%氯化钠注射液并注入胸、腹腔。并通过治疗前后引流量变化、影像学变化、血制品的用量和输血时间间隔来评价疗效。结果 rmhTNF-α能有效控制进展期肺癌患者的恶性胸腹水，治疗后肺部CT、腹部B超显示胸腹水减少，胸腹水引流量减少(P＜0.01)，输注血制品的总量减少、时间间隔延长。结论 rmhTNF-α可能对常规治疗无效的恶性浆膜腔积液有效，但机制还不甚明了，有待进一步系统研究。
　　목적보고1례중조개구인종류배사인자-α(rmhTNF-α)치료노년악성흉、복강적액적림상병례。방법2010년아과수치1례폐암병흉복강적액환자，급여류치흉강화복강인류관，매천방진흉、복수병기록인류량후，분별주입지새미송린산납주사액2 mg、5 mg，연후분별장rmhTNF-α200만U、500만U용우20 ml 0.9%록화납주사액병주입흉、복강。병통과치료전후인류량변화、영상학변화、혈제품적용량화수혈시간간격래평개료효。결과 rmhTNF-α능유효공제진전기폐암환자적악성흉복수，치료후폐부CT、복부B초현시흉복수감소，흉복수인류량감소(P＜0.01)，수주혈제품적총량감소、시간간격연장。결론 rmhTNF-α가능대상규치료무효적악성장막강적액유효，단궤제환불심명료，유대진일보계통연구。
Objective To report the recombinant human tumor necrosis factor-alpha (rmhTNF-α) in treatment of malignant pleuroperitoneal cavity effusion in an elderly patient with non-small cell lung cancer (NSCLC). Methods A drainage tube was placed in a lung cancer patient with pleuroperitoneal cavity effusion admitted to our department in 2010 to drain the pleuroperitoneal cavity effusion every day with its volume recorded, followed by injection of 2 mg and 5 mg dexamethasone and 20 ml normal saline containing 2×106 U/5×106 U rmhTNF-αinto the pleuroperitoneal cavity. The therapeutic effect was assessed by measuring the volume of drained pleuroperitoneal effusion, imaging, infusion amount of blood products, and blood transfusion interval. Results The rmhTNF-αcould effectively control the malignant pleuroperitoneal cavity effusion in patients with progressive lung cancer, with their pleuroperitoneal cavity effusion and infusion amount of blood products reduced, and their blood transfusion interval shortened after treatment as shown in lung CT and abdominal ultrasongraphy(P < 0.01). Conclusion The rmhTNF-αis effective for malignant pleuroperitoneal effusion failing to conventional treatment. However, its mechanism is still unclear, thus needing to be further studied.