恩度联合胸腔热灌注化疗对非小细胞肺癌患者循环内皮细胞影响研究

发布时间：2019-04-17 17:02

【摘要】：目的:观察恩度联合胸腔热灌注化疗对非小细胞肺癌患者胸腔积液及循环内皮细胞的影响。方法:以62例非小细胞肺癌患者为研究对象,随机分为对照组30例和观察组32例,经胸腔穿刺引流后,对照组将20mg顺铂注入胸腔内,行胸腔循环热灌注1小时,循环结束后,给予胸腔内注入顺铂40mg-60mg。每周2次,连用2周;观察组:将20mg顺铂注入胸腔内,行胸腔循环热灌注1小时,循环结束后,给予胸腔内注入顺铂40mg-60mg并注入恩度30mg。每周2次,连用2周;观察两组患者胸腔积液的缓解情况及不良反应率,检测两组患者治疗前后外周血CECs及a CECs的含量。结果:治疗后对照组胸腔积液总有效率为53.33%:观察组总有效率为86.38%,两组总有效率有统计学差异(P0.05)。治疗后对照组不良反应(均为I II级)发生人次30例,观察组不良反应(均为I II级)发生人次29例,两组不良反应发生率无统计学差异(P≥0.05)。经治疗后,对照组CECs及a CECs含量相对治疗前无统计学差异(P0.05),观察组CECs及a CECs含量相对治疗前明显降低,有统计学差异(P0.05);不同疗效间患者CECs及a CECs含量比较,对照组CR+PR患者相对SD+PD患者CECs及a CECs降低,观察组CR+PR患者相对SD+PD患者CECs及a CECs明显降低,差异均有统计学意义(P0.05)。结论:通过采用恩度联合胸腔热灌注化疗的治疗方法,使非小细胞肺癌患者胸腔积液改善明显,生活质量改善显著,并未增加不良反应率。同时可降低患者外周血CECs和a CECs含量。胸腔积液控制情况与外周血CECs及a CECs含量呈负相关,即胸腔积液疗效越显著,CECs及a CEC含量下降越明显。
[Abstract]:Aim: to observe the effect of Endo combined with intrapleural hyperthermic chemotherapy on pleural effusion and circulating endothelial cells in patients with non-small cell lung cancer (NSCLC). Methods: 62 patients with non-small cell lung cancer (NSCLC) were randomly divided into control group (n = 30) and observation group (n = 32). After thoracic puncture and drainage, 20mg cisplatin was injected into the thoracic cavity of the control group. Cisplatin was injected into the thoracic cavity of 40 mg / g and 60 mg 路kg-1, respectively. The observation group: 20mg cisplatin was injected into the thoracic cavity for 1 hour, and after the end of the circulation, cisplatin 40mg-60mg was injected into the chest cavity and Endo 30 mg 路kg-1 was injected into the chest cavity. Two times a week for 2 weeks, the remission and adverse reaction rate of pleural effusion in two groups were observed, and the levels of CECs and a-CECs in peripheral blood were measured before and after treatment. Results: after treatment, the total effective rate of pleural effusion was 53.33% in the control group, 86.38% in the observation group, and there was statistical difference between the two groups (P0.05). There were 30 cases in the control group (all of them I / II grade) and 29 cases in the observation group (I / II grade) after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). After treatment, the contents of CECs and a-CECs in the control group were not significantly different before treatment (P0.05), but the CECs and a-CECs contents in the observation group were significantly lower than those before treatment (P0.05). The contents of CECs and a-CECs in patients with different therapeutic effects were significantly lower than those in patients with SD PD in the control group (P < 0.05), and the CECs and a-CECs in the patients with CR PR in the observation group were significantly lower than those in the SD PD patients in the observation group (P0.05). Conclusion: the pleural effusion and quality of life of patients with non-small cell lung cancer (NSCLC) were significantly improved by Endo combined with intrapleural hyperthermic chemotherapy, and the adverse reaction rate was not increased. At the same time, the contents of CECs and a CECs in the peripheral blood of the patients were decreased. The control of pleural effusions was negatively correlated with the contents of CECs and a CECs in peripheral blood. That is to say, the more effective the pleural effusions were, the more obvious the contents of CECs and a CEC decreased.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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