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目的观察重组人血管内皮抑素联合奈达铂腹腔热灌注化疗治疗消化道肿瘤并恶性腹腔积液的疗效和安全性,及其对T淋巴细胞亚群的影响。方法消化道肿瘤并恶性腹腔积液患者64例,随机分为观察组33例和对照组31例,2组化疗均给予卡培他滨口服,第1~14天,21d为1个周期,共2个周期;化疗第1个周期第1、5天,对照组给予奈达铂腹腔热灌注化疗,观察组给予重组人血管内皮抑素~+奈达铂腹腔热灌注化疗。治疗2个周期后评定2组疗效,并应用流式细胞仪检测2组治疗前和治疗2周期后CD4~+、CD8~+T细胞阳性率,计算CD4~+/CD8~+。结果观察组总有效率(87.88%)高于对照组(64.52%)(P<0.05);对照组治疗后CD4~+、CD8~+T细胞阳性率及CD4~+/CD8~+与治疗前比较差异无统计学意义(P>0.05);观察组治疗后CD4~+T细胞阳性率[(55.23±7.36)%]、CD4~+/CD8~+(1.59±0.19)较治疗前[(45.78±5.12)%、1.05±0.26]增高且高于对照组治疗后[(46.79±9.22)%、1.08±0.23],CD8~+T细胞阳性率[(34.89±5.32)%]较治疗前[(43.66±3.94)%]下降且低于对照组治疗后[(43.15±9.31)%],差异均有统计学意义(P<0.05);2组不良反应均为Ⅰ~Ⅱ级。结论在化疗基础上应用重组人血管内皮抑素联合奈达铂腹腔热灌注治疗消化道肿瘤并恶性腹腔积液疗效满意,可改善患者免疫功能,安全性好。
Objective To observe the efficacy and safety of recombinant human endostatin combined with nedaplatin intraperitoneal hyperthermic perfusion chemotherapy in the treatment of gastrointestinal cancer with malignant ascites and its effect on T lymphocyte subsets. Methods Sixty-four patients with malignant ascites and malignant ascites were randomly divided into observation group (n = 33) and control group (n = 31). The two groups were given capecitabine orally. 2 cycles. On the 1st and 5th days of the first cycle of chemotherapy, the control group was treated with intraperitoneal hyperthermic intraperitoneal chemotherapy of nedaplatin, and the observation group was given intraperitoneal hyperthermic perfusion chemotherapy of recombinant human endostatin and nedaplatin. After 2 cycles of treatment, the curative effect of two groups was evaluated. The positive rates of CD4 ~ + and CD8 ~ + T cells in two groups before and after treatment were detected by flow cytometry. CD4 ~ + / CD8 ~ + was calculated. Results The total effective rate (87.88%) in observation group was higher than that in control group (64.52%) (P <0.05). The positive rates of CD4 ~ +, CD8 ~ + T cells and CD4 ~ + / CD8 ~ (55.23 ± 7.36)%], CD4 ~ + / CD8 ~ + (1.59 ± 0.19) in the observation group were significantly higher than those before treatment [(45.78 ± 5.12% and 1.05 ± 0.26, respectively) were higher than those in the control group (46.79 ± 9.22% vs 1.08 ± 0.23%, 34.89 ± 5.32%, respectively) (43.66 ± 3.94)%] were lower than those in the control group [(43.15 ± 9.31)%], the difference was statistically significant (P <0.05). The adverse reactions of the two groups were grade Ⅰ ~ Ⅱ. Conclusions The application of recombinant human endostatin combined with nedaplatin intraperitoneal hyperthermic perfusion in the treatment of gastrointestinal cancer with malignant ascites based on the chemotherapy is satisfactory and can improve the immune function of patients with good safety.