目的 探討注射用甘露聚糖肽聯(lián)合PC方案（注射用培美曲塞二鈉、卡鉑注射液）治療肺腺癌惡性胸腔積液的臨床療效。方法 選取2013年1月-2016年12月南京市胸科醫(yī)院呼吸科收治的肺腺癌合并惡性胸腔積液患者80例為研究對象，所有患者以隨機(jī)抽樣法分為對照組和治療組，每組各40例。對照組靜脈滴注注射用培美曲塞二鈉500 mg/m²、卡鉑注射液300 mg/m²，1次/3周。治療組在對照組基礎(chǔ)上胸腔內(nèi)注射注射用甘露聚糖肽，30 mg/次，2次/周。兩組患者均治療6周。觀察兩組的臨床療效，比較兩組的胸腔積液病理陽性率。結(jié)果 治療后，對照組和治療組的有效率分別為65.0%、85.0%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療2、4周后，對照組胸腔積液病理陽性率分別為67.5%、42.5%；治療組胸腔積液病理陽性率分別為37.5%、17.5%，兩組病理陽性率比較差異有統(tǒng)計學(xué)意義（P<0.05）。兩組骨髓抑制、胃腸道反應(yīng)、發(fā)熱或胸痛癥狀比較差異均無統(tǒng)計學(xué)意義。結(jié)論 注射用甘露聚糖肽聯(lián)合PC方案治療肺腺癌惡性胸腔積液具有較好的臨床療效，可降低胸腔積液病理陽性率，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Mannatide for injection combined with PC chemotherapy (Pemetrexed Disodium for injection combined with Carboplatin Injection) in treatment of malignant pleural effusion of lung adenocarcinoma. Methods Patients (80 cases) with malignant pleural effusion of lung adenocarcinoma in Department of Respiratory Medicine of Nanjing Chest Hospital from January 2013 to December 2016 were randomly divided into control and treatment groups, and each group had 40 cases. Patients in the control group were iv administered with Pemetrexed Disodium for injection (500 mg/m²) and Carboplatin Injection (300 mg/m²), once every 3 weeks. Patients in the treatment group were ip injection administered with Mannatide for injection on the basis of the control group, 30 mg/time, twice weekly. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacies were evaluated, and the pathological positive rates of pleural effusion in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 65.0% and 85.0%, respectively, and there was difference between two groups (P<0.05). After treatment for 2 and 4 weeks, the pathological positive rates of pleural effusion in the control group were 67.5% and 42.5%, respectively, the pathological positive rates of pleural effusion in the treatment group were 37.5% and 17.5%, respectively, and there was difference between two groups (P<0.05). There were no significant differences in myelosuppression, gastrointestinal reaction, fever or chest pain between two groups. Conclusion Mannatide for injection combined with PC chemotherapy has clinical curative effect in treatment of malignant pleural effusion of lung adenocarcinoma, and can decrease pathological positive rates of pleural effusion, with good safety, which has a certain clinical application value.

南京市"十三五醫(yī)學(xué)科技創(chuàng)新平臺"重大課題（ZDX16012）