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目的研究重组人血管内皮抑素(恩度)联合顺铂胸腔内注射治疗肺腺癌恶性胸腔积液的近期疗效与安全性。方法 90例肺腺癌恶性胸腔积液患者随机分为恩度联合顺铂组、恩度组和顺铂组,具体方法:恩度30mg/次,顺铂30mg/次,每两天一次,连续3次为1疗程,最多可连续接受2疗程治疗。评估三组的近期疗效、生活质量(QOL)和不良反应。结果恩度联合顺铂组有效率、QOL改善率分别为83.3%、76.7%,恩度组53.3%、63.3%,顺铂组50%、60%。恩度联合顺铂组有效率高于恩度组、顺铂组,组间差异有统计学意义(P=0.014)。三组QOL改善率差异无统计学意义。恩度联合顺铂组、顺铂组不良反应发生率比较差异无统计学意义,恩度组低于上述两组,差异具统计学意义(P<0.017)。结论恩度联合顺铂胸腔内注射治疗肺腺癌胸腔积液可明显提高缓解率,改善生活质量,且不良反应小,具有较好的临床疗效及用药安全性。
Objective To study the short-term efficacy and safety of recombinant human endostatin (Endo) combined with cisplatin intrathoracic injection in the treatment of malignant pleural effusion of lung adenocarcinoma. Methods Ninety percent of patients with malignant lung pleural effusion of lung adenocarcinoma were randomly divided into four groups: Endo plus Cisplatin group, Endo group and Cisplatin group. Specific methods: Endo 30 mg/time, Cisplatin 30 mg/time, once every two days, continuous 3 times for a course of treatment, up to 2 consecutive courses of treatment. The short-term efficacy, quality of life (QOL), and adverse reactions were evaluated in the three groups. Results The degree of effectiveness, QOL improvement rate of Endo and cisplatin group were 83.3% and 76.7%, 53.3% and 63.3% in Endo group and 50% and 60% in Cisplatin group, respectively. The degree of effectiveness of the Endo and Cisplatin group was higher than that of the Endo group and Cisplatin group, and the difference between the groups was statistically significant (P=0.014). There was no significant difference in the QOL improvement rate among the three groups. There was no significant difference in the incidence of adverse reactions between Endo and Cisplatin group and Cisplatin group. Endo group was lower than the above two groups, and the difference was statistically significant (P<0.017). Conclusion Endodine combined with cisplatin intrapleural injection in the treatment of pulmonary adenocarcinoma pleural effusion can significantly improve the remission rate, improve the quality of life, and the adverse reactions are small, with good clinical efficacy and drug safety.