目的 探究纳武利尤单抗注射液联合盐酸安罗替尼胶囊治疗晚期非小细胞肺癌的临床疗效。方法 选取2019年1月—2020年1月临汾市中心医院收治的60例晚期非小细胞肺癌患者为研究对象，根据患者治疗方法不同分为对照组（29例）和治疗组（31例）。对照组患者早餐前口服盐酸安罗替尼胶囊，12 mg/次，1次/d，连续服药2周，停药1周。治疗组患者在对照组治疗的基础上静脉输注纳武利尤单抗注射液，3 mg/kg，1次/2周，评估患者耐受性和疗效。两组患者均持续治疗9周。观察两组近期临床疗效，比较治疗前后两组生活质量、T淋巴细胞亚群、血管内皮细胞生长因子（VEGF）水平变化和生存情况。结果 治疗后，治疗组客观缓解率（ORR）、疾病控制率（DCR）均较高于对照组，组间比较差异具有显著差异（P<0.05）。治疗后，两组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺均明显升高，CD8⁺、VEGF均明显降低（P<0.05）；治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺均明显高于对照组，CD8⁺、VEGF均明显低于对照组（P<0.05）。治疗后2、4、6个月，两组EORTC QLQ-C30总评分均明显降低（P<0.05），且治疗组EORTC QLQ-C30总评分明显低于同期对照组（P<0.05）。治疗后，治疗组中位无进展生存期（PFS）、总生存期（OS）较对照组明显增长（P<0.05）。结论 纳武利尤单抗注射液联合盐酸安罗替尼胶囊治疗晚期非小细胞肺癌具有较好的临床疗效，可改善患者的生活质量，调节患者免疫功能，降低VEGF水平，且不增加不良反应。

Objective To investigate the efficacy of Nivolumab Injection combined with Anlotinib Hydrochloride Capsules in treatment of advanced non-small cell lung cancer. Methods Patients (60 cases) with advanced non-small cell lung cancer in Linfen Central Hospital from January 2019 to January 2020 were divided into the control group (29 cases) and the treatment group (31 cases) according to different treatments. Patients in the control group were po administered with Anlotinib Hydrochloride Capsules before breakfast, 12 mg/time, once daily, the drug was taken continuously for 2 weeks and stopped for 1 week. Patients in the treatment group were iv administered with Nivolumab injection on the basis of the control group, 3 mg/kg, once every 2 weeks, and tolerance and efficacy were assessed. Both groups were treated continuously for 9 weeks. After treatment, the clinical efficacies were evaluated, and the quality of life, the T lymphocyte subsets, VEGF levels, and survival status in two groups were compared. Results After treatment, the objective remission rate (ORR) and disease control rate (DCR) in the treatment group were higher than those in the control group, and there was significant difference between the groups (P < 0.05). After treatment, CD3⁺, CD4⁺, CD₄⁺/CD8⁺ in the two groups were significantly higher than those before treatment, but CD8⁺ and VEGF were significantly lower than those before treatment (P < 0.05). CD3⁺, CD4⁺, CD4⁺/CD8⁺ in the treatment group were significantly higher than those in the control group, but CD8⁺ and VEGF were significantly lower than those in the control group (P < 0.05). At 2, 4, and 6 months after treatment, EORTC QLQ-C30 total scores in two groups were significantly lower than that before treatment (P < 0.05), and EORTC QLQ-C30 total scores in the treatment group were significantly lower than that in the control group at the same time (P < 0.05). After treatment, the median progression free survival (PFS) and overall survival (OS) in the treatment group were significantly higher than those in the control group (P < 0.05). Conclusion Nivolumab Injection combined with Anlotinib Hydrochloride Capsules has clinical curative in treatment of advanced non-small cell lung cancer, can improve the quality of life of patients, regulate the immune function of patients, reduce the level of VEGF, and do not increase the incidence of adverse reactions.

R979.1

临汾市科技重点研发计划（2135）