重组人血管内皮抑制素治疗晚期非小细胞肺癌的疗效及其对肺功能的影响

马必东 黄志有 张济周

[摘要] 目的 探討重组人血管内皮抑制素（rhES）治疗晚期非小细胞肺癌（NSCLC）的临床疗效及其对患者肺功能的影响。 方法 选取2016年5月～2019年5月于我院就诊的168例NSLCL患者为研究对象，随机分为实验组与对照组，每组各84例。对照组采用常规长春瑞滨+顺铂（NP）方案，实验组在对照组治疗基础上加用重组人血管内皮抑制素治疗，两组患者均以21 d为1个疗程，均连续治疗1个疗程，比较两组患者临床疗效、治疗过程中不良反应发生率、治疗前后血清血管内皮生长因子（VEGF）、癌胚抗原（CEA）、糖类抗原125（CA125）、组织多肽特异性抗原（TPS）水平、KPS评分及肺功能指标变化。 结果 实验组治疗总有效率显著高于对照组，差异有统计学意义（80.95% vs. 42.86%，P<0.05）;治疗后两组患者血清VEGF、CEA、CA125、TPS水平较治疗前均显著降低，且实验组显著低于对照组，差异具有统计学意义（P<0.05）;治疗后两组患者生活质量（QOL）变化比较，实验组QOL改善占比显著高于对照组（P<0.05）;两组患者不良反应比较，差异无统计学意义（P>0.05）;治疗后两组患者肺功能较前均显著好转，且实验组肺功能更优于对照组，差异有统计学意义（P<0.05）。 结论 晚期NSCLC患者采用rhES治疗的临床疗效佳，可降低血清VEGF及肺癌相关肿瘤血清学指标，提高患者术后生活质量及肺功能，且不增加不良反应，值得临床进一步推广应用。

[关键词] 非小细胞肺癌;重组人血管内皮抑制素;疗效;肺功能

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2020）15-0096-05

Therapeutic efficacy of recombinant human endostatin for advanced non-small cell lung cancer and its effect on lung function

MA Bidong   HUANG Zhiyou   ZHANG Jizhou

Department of Oncology， Wenzhou Hospital of Traditional Chinese Medicine in Zhejiang Province， Wenzhou   325000， China

[Abstract] Objective To investigate therapeutic efficacy of recombinant human endostatin（rhES） for advanced non-small cell lung cancer（NSCLC） and its effect on lung function. Methods 168 patients with NSCLC treated in our hospital from May 2016 to May 2019 were selected as research subjects and randomly divided into experimental group and control group， with 84 cases in each group. The control group was treated with conventional NVB+DDP（NP） scheme， while the experimental group was treated with rhES on the basis of the control group. Both groups were treated for 21 days as a course of treatment， and both groups were treated for one course continuously. The changes of clinical efficacy， incidence of adverse reactions（ADRs） in the treatment process， serum vascular endothelial growth factor（VEGF）， carcinoembryonic antigen（CEA）， carbohydrate antigen 125（CA125）， tissue polypeptide specific antigen（TPS） level， KPS scores and lung function indexes before and after treatment were compared between the two groups. Results The total effective rate in the experimental group was significantly higher than that in the control group， with statistically significant difference（80.95% vs. 42.86%， P<0.05）. After treatment， the levels of serum VEGF， CEA， CA125 and TPS in the two groups were significantly lower than those before treatment， and the experimental group was significantly lower than the control group， with statistically significant difference（P<0.05）. When the changes of quality of life（QOL） were compared between the two groups， the improvement proportion of QOL in the experimental group was significantly higher than that in the control group（P<0.05）. There was no statistically significant difference in adverse reactions between the two groups（P> 0.05）. After treatment， the lung function of the two groups of patients was significantly improved compared with that before treatment and the lung function of the experimental group was superior to that of the control group， with statistically significant difference（P<0.05）. Conclusion In the treatment of advanced NSCLS patients， the clinical therapy of rhES is effective. It can reduce serum VEGF and serum indexes of lung cancer-related tumors， improve postoperative quality of life and lung function of patients without increasing ADRs. It is worthy of further clinical promotion and application.

[Key words] Non-small cell lung cancer（NSCLS）; Recombinant human endostatin（rhES）; Therapeutic efficacy; Lung function

肺癌是一种临床十分常见的恶性肿瘤，其主要源于支气管黏膜或腺体，具有较高的病死率及复发转移率。在肺癌的分类中，非小细胞肺癌（non-small cell lung cancer， NSCLC）约占80%，由于早期诊断不足多数患者在确诊时常为肿瘤中晚期，治疗效果较差[1]。目前临床对晚期NSCLC一般以静脉全身化疗为主，但其临床效果有限且具有一定的不良反应。重组人血管内皮抑制素（recombinant human endostatin，rhES，商品名：恩度）是一种具有抑制肿瘤新生血管形成、抗肿瘤活性作用的药物，在国内现被推荐用于治疗晚期NSCLC患者[2]。有研究显示其在肿瘤患者的治療中具有近期疗效佳、靶向明确、毒副作用小等优点[3]。……