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目的探讨注射用甘露聚糖肽联合PC方案(注射用培美曲塞二钠、卡铂注射液)治疗肺腺癌恶性胸腔积液的临床疗效。方法选取2013年1月—2016年12月南京市胸科医院呼吸科收治的肺腺癌合并恶性胸腔积液患者80例为研究对象,所有患者以随机抽样法分为对照组和治疗组,每组各40例。对照组静脉滴注注射用培美曲塞二钠500 mg/m~2、卡铂注射液300 mg/m~2,1次/3周。治疗组在对照组基础上胸腔内注射注射用甘露聚糖肽,30 mg/次,2次/周。两组患者均治疗6周。观察两组的临床疗效,比较两组的胸腔积液病理阳性率。结果治疗后,对照组和治疗组的有效率分别为65.0%、85.0%,两组比较差异有统计学意义(P<0.05)。治疗2、4周后,对照组胸腔积液病理阳性率分别为67.5%、42.5%;治疗组胸腔积液病理阳性率分别为37.5%、17.5%,两组病理阳性率比较差异有统计学意义(P<0.05)。两组骨髓抑制、胃肠道反应、发热或胸痛症状比较差异均无统计学意义。结论注射用甘露聚糖肽联合PC方案治疗肺腺癌恶性胸腔积液具有较好的临床疗效,可降低胸腔积液病理阳性率,安全性较好,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of injecting mannatide combined with PC (pemetrexed disodium injection and carboplatin injection) in the treatment of malignant pleural effusion of lung adenocarcinoma. Methods From January 2013 to December 2016, 80 patients with malignant pleural effusion in lung adenocarcinoma admitted to Department of Respiratory Diseases, Nanjing Chest Hospital were enrolled. All patients were divided into control group and treatment group by random sampling. Group of 40 cases. The control group received intravenous infusion of pemetrexed 500 mg / m ~ 2, carboplatin 300 mg / m ~ 2, once / 3 weeks. The treatment group was injected intraperitoneally with mannan peptide for 30 mg / time, twice a week on the basis of the control group. Both groups were treated for 6 weeks. The clinical efficacy of the two groups was observed, and the positive rate of pleural effusion pathology was compared between the two groups. Results After treatment, the effective rates of the control group and the treatment group were 65.0% and 85.0%, respectively, with significant difference between the two groups (P <0.05). After 2 and 4 weeks of treatment, the positive rate of pleural effusion in the control group was 67.5% and 42.5%, respectively. The positive rate of pleural effusion in the treatment group was 37.5% and 17.5% respectively, the difference was statistically significant (P <0.05). Two groups of bone marrow suppression, gastrointestinal reactions, fever or chest pain were no significant differences in the symptoms. Conclusion Mannan peptide injection combined with PC regimen has good clinical efficacy in the treatment of malignant pleural effusion of lung adenocarcinoma, which can reduce the positive rate of pleural effusion pathology, which is safe and has some clinical application value.