目的 分析華蟾素注射液聯(lián)合鹽酸安羅替尼膠囊治療惡性漿膜腔積液的臨床效果。方法 選取2023年1月—2024年1月無錫市錫山人民醫(yī)院收治的64例惡性漿膜腔積液患者，根據(jù)隨機數(shù)字表法將患者分為對照組（31例）和治療組（30例）。對照組患者餐后30 min溫水送服鹽酸安羅替尼膠囊，體質(zhì)量≤60 kg患者，8 mg/次，體質(zhì)量＞60 kg患者，12 mg/次，1次/d。治療組在對照組基礎(chǔ)上于漿膜腔穿刺置管術(shù)排出積液后灌注華蟾素注射液，胸腔灌注40～125 mL，腹腔灌注40～150 mL，心包灌注10～50 mL，使用生理鹽水稀釋，每周3次。兩組患者均在2周治療完成后，持續(xù)觀察至少4周，結(jié)束時評估療效。比較兩組患者的臨床療效、健康狀況、積液相關(guān)指標(biāo)、不良反應(yīng)、生存情況。結(jié)果 治療組的疾病控制率為93.33%，高于對照組的疾病控制率70.97%（P＜0.05）。治療后，兩組KPS評分較治療前顯著升高（P＜0.05），治療組KPS評分高于對照組（P＜0.05）。治療后，兩組積液中血管內(nèi)皮生長因子（VEGF）、低氧誘導(dǎo)因子-1α（HIF-1α）水平較治療前顯著降低（P＜0.05），治療組積液中VEGF、HIF-1α水平低于對照組（P＜0.05）。治療組患者高血壓、皮疹、腹瀉3級占比低于對照組（P＜0.05），無進展生存時間長于對照組（P＜0.05）。結(jié)論 華蟾素注射液聯(lián)合鹽酸安羅替尼膠囊治療惡性漿膜腔積液能增效減毒，可改善患者健康狀態(tài)，降低積液中VEGF、HIF-1α水平，延長患者無進展生存時間。

Objective To analyze the clinical efficacy of Cinobufacin Injection combined with Anlotinib Hydrochloride Capsules in treatment of malignant serous cavity effusion.Methods 64 Malignant serous cavity effusion patients admitted to Wuxi Xishan People's Hospital from January 2023 to January 2024 were selected and divided into control group (31 cases) and treatment group (30 cases) using a random number table method. The control group received oral administration of Anlotinib Hydrochloride Capsules with warm water 30 min after meals, once daily, 8 mg/time for patients with a body weight of ≤ 60 kg, and 12 mg/time for patients with a body weight of >60 kg. On the basis of the control group, the treatment group was treated with Cinobufacin Injection. After the discharge of fluid through the serosal cavity puncture and catheterization, Cinobufacin Injection was infused into the chest cavity with 40 — 125 mL, the abdominal cavity with 40 — 150 mL, and the pericardium with 10 — 50 mL, diluted with physiological saline, three times weekly. Both groups of patients were observed continuously for at least 4 weeks after completing 2 weeks of treatment, and the efficacy was evaluated at the end. The clinical efficacy, health status, fluid related indicators, adverse reactions, and survival status of two groups of patients were compared.Results The disease control rate of the treatment group was 93.33%, which was higher than the disease control rate of 70.97% in the control group (P < 0.05). After treatment, the KPS scores of both groups were significantly increased compared to those before treatment (P < 0.05), and the KPS scores in the treatment group were higher than those in the control group (P < 0.05). After treatment, the fluid levels of VEGF and HIF-1α in both groups were significantly reduced compared to those before treatment (P < 0.05). The fluid levels of VEGF and HIF-1α in the treatment group were lower than those in the control group (P < 0.05). The proportion of grade 3 hypertension, rash, and diarrhea in the treatment group was lower than that in the control group (P < 0.05), and the progression free survival time was longer than that in the control group (P < 0.05).Conclusion The combination of Cinobufacin Injection and Anlotinib Hydrochloride Capsules can enhance efficacy and reduce toxicity in treatment of malignant serous cavity effusion, improve the health status of patients, reduce the fluid levels of VEGF and HIF-1α, and prolong the progression free survival time of patients.

R979.1

江蘇大學(xué)臨床醫(yī)學(xué)科技發(fā)展基金項目（JLY2021126）