目的 探討甘露聚糖肽聯(lián)合斑蝥酸鈉維生素B6治療惡性胸腔積液的臨床療效。方法 收集2016年1月-2017年1月在溧陽市人民醫(yī)院進(jìn)行治療的惡性胸腔積液患者78例，根據(jù)用藥的差別分為對照組（39例）和治療組（39例）。對照組胸腔注入斑蝥酸鈉維生素B6注射液，50 mL加入20 mL生理鹽水，1次/周；治療組在對照組的基礎(chǔ)上胸腔注入甘露聚糖肽注射液，80 mL加入20 mL生理鹽水，1次/周。兩組患者均經(jīng)過4周治療。評價(jià)兩組患者臨床療效，同時(shí)比較治療前后兩組患者胸水指標(biāo)和KPS評分變化。結(jié)果 治療后，對照組和治療組的臨床總有效率分別為64.10%和84.62%。兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組癌胚抗原（CEA）、胰島素樣生長因子結(jié)合蛋白-2（IGFBP-2）、基質(zhì)金屬蛋白酶-9（MMP-9）水平均顯著降低，干擾素-γ（IFN-γ）和白細(xì)胞介素-2（IL-2）水平顯著增高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)水平明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組KPS評分均升高（P<0.05）；且治療組患者比對照組升高更明顯（P<0.05）。結(jié)論 甘露聚糖肽聯(lián)合斑蝥酸鈉維生素B6治療惡性胸腔積液可有效降低癌胚抗原水平，增強(qiáng)機(jī)體免疫功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of mannatide combined with vitamin sodium and vitamin B6 in treatment of malignant pleural effusion. Methods Patients (78 cases) with malignant pleural effusion in Liyang City People's Hospital from January 2016 to January 2017 were divided into control (39 cases) and treatment (39 cases) groups according to different treatments. Patients in the control group were intrapleural injection administered with Disodium Cantharidinate and Vitamin B6 Injection, 50 mL added into normal saline 20 mL, once weekly. Patients in the treatment group were intrapleural injection administered with Mannatide Injection on the basis of the control group, 80 mL added into normal saline 20 mL, once weekly. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the change of pleural fluid indexes and KPS scores in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 64.10% and 84.62%, respectively, and there were differences between two groups (P<0.05). After treatment, the CEA, IGFBP-2 and MMP-9 levels in two groups were significantly decreased, IFN-γ and IL-2 levels were significantly increased, and the difference was statistically significant in the same group (P<0.05). And these indexes levels in the treatment group were obviously better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the KPS score in two groups was significantly increased (P<0.05). And the KPS score in the treatment group increased more obviously than that in the control group (P<0.05). Conclusion Mannatide combined with vitamin sodium and vitamin B6 can reduce carcinoembryonic antigen levels and enhance immune function in treatment of malignant pleural effusion, which has a certain clinical application value.