CAJ | 학술논문

目的：观察顺铂联合恩度胸腔灌注治疗肺癌恶性胸腔积液的临床疗效和不良反应及其对血管内皮生长因子（VEGF）的影响。方法选取45例肺癌恶性胸腔积液的患者为研究对象，接受顺铂联合恩度胸腔灌注的21例为实验组，单用顺铂胸腔灌注的24例为对照组。两组均于第1～3天采用顺铂胸腔灌注，实验组则在第4天给予恩度胸腔灌注。每4周1次，4周为1周期，2周期后评价疗效和不良反应。两组均在第1周期的治疗前和治疗第3、7天采用ELISA法检测胸腔积液和血清VEGF浓度。结果两组治疗后近期有效率分别为80．9％和58．3％，差异具有统计学意义（P＜0．05）。两组治疗第3天胸腔积液和血清VEGF浓度相比于治疗前均明显下降（P＜0．05），但两组之间差异无统计学意义（P＞0．05）。实验组治疗第7天的胸腔积液和血清VEGF浓度相比于第3天均明显下降（P＜0．05），对照组差异无统计学意义（P＞0．05）。两组不良反应均可耐受。结论顺铂联合恩度胸腔灌注治疗肺癌恶性胸腔积液近期疗效可观，不良反应可耐受，恩度有明显的抑制VEGF表达的功能。
목적：관찰순박연합은도흉강관주치료폐암악성흉강적액적림상료효화불량반응급기대혈관내피생장인자（VEGF）적영향。방법선취45례폐암악성흉강적액적환자위연구대상，접수순박연합은도흉강관주적21례위실험조，단용순박흉강관주적24례위대조조。량조균우제1～3천채용순박흉강관주，실험조칙재제4천급여은도흉강관주。매4주1차，4주위1주기，2주기후평개료효화불량반응。량조균재제1주기적치료전화치료제3、7천채용ELISA법검측흉강적액화혈청VEGF농도。결과량조치료후근기유효솔분별위80．9％화58．3％，차이구유통계학의의（P＜0．05）。량조치료제3천흉강적액화혈청VEGF농도상비우치료전균명현하강（P＜0．05），단량조지간차이무통계학의의（P＞0．05）。실험조치료제7천적흉강적액화혈청VEGF농도상비우제3천균명현하강（P＜0．05），대조조차이무통계학의의（P＞0．05）。량조불량반응균가내수。결론순박연합은도흉강관주치료폐암악성흉강적액근기료효가관，불량반응가내수，은도유명현적억제VEGF표체적공능。
Objective To observe the curative effects and toxic and adverse effects of pleural infusion of cispla‐tin combined with endostar for treating pulmonary carcinoma complicating malignant pleural effusion and its influence on vascular endothelial growth factor(VEGF) .Methods 45 cases of lung cancer complicating malignant pleural effu‐sion were selected .21 cases undergone the pleural infusion of cisplatin combined with endostar were taken as the ex‐perimental group ,while the rest 24 cases undergone the simple pleural infusion of cisplatin were taken as the control group .The two groups were given the pleural perfusion of cisplatin on 1-3 d .The experimental group was given the pleural perfusion of endostar on 4 d ,once every 4 weeks and 4 weeks as 1 cycle .The curative effects and toxic and ad‐verse reactions were evaluated after 2 cycles .Pleural fluid and serum VEGF levels were detected before the first cy‐cle ,on 3 ,7 d of treatment by ELISA .Results The short‐term effective rates of the two groups after treatment were 80 .9% and 58 .3% respectively ,with statistically significant difference (P<0 .05);pleural fluid and serum VEGFs levels on 3 d of treatment in the two groups were significantly reduced compared with before treatment ,the differ‐ences were statistically significant(P<0 .05) ,but the differences between the two groups had no statistical signifi‐cance(P>0 .05);pleural fluid and serum VEGFs levels on 7 d in the experimental group were significantly decreased compared with those on 3 d(P<0 .05) ,but the differences of the control group were not statistically significant (P>0 .05);the toxic and adverse reactions of the two groups could be tolerated .Conclusion Pleural infusion of cisplatin combined with endostar has obvious short‐term effects in treating pulmonary carcinoma complicating malignant pleu‐ral effusion ,and the toxic and adverse reactions can be tolerated .Endostar has obvious inhibition on VEGF expres‐sion .