目的 探讨注射用甘露聚糖肽联合PC方案（注射用培美曲塞二钠、卡铂注射液）治疗肺腺癌恶性胸腔积液的临床疗效。方法 选取2013年1月-2016年12月南京市胸科医院呼吸科收治的肺腺癌合并恶性胸腔积液患者80例为研究对象，所有患者以随机抽样法分为对照组和治疗组，每组各40例。对照组静脉滴注注射用培美曲塞二钠500 mg/m²、卡铂注射液300 mg/m²，1次/3周。治疗组在对照组基础上胸腔内注射注射用甘露聚糖肽，30 mg/次，2次/周。两组患者均治疗6周。观察两组的临床疗效，比较两组的胸腔积液病理阳性率。结果 治疗后，对照组和治疗组的有效率分别为65.0%、85.0%，两组比较差异有统计学意义（P<0.05）。治疗2、4周后，对照组胸腔积液病理阳性率分别为67.5%、42.5%；治疗组胸腔积液病理阳性率分别为37.5%、17.5%，两组病理阳性率比较差异有统计学意义（P<0.05）。两组骨髓抑制、胃肠道反应、发热或胸痛症状比较差异均无统计学意义。结论 注射用甘露聚糖肽联合PC方案治疗肺腺癌恶性胸腔积液具有较好的临床疗效，可降低胸腔积液病理阳性率，安全性较好，具有一定的临床推广应用价值。

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"十三五医学科技创新平台"重大课题（ZDX16012）