RESUMO
Objective To investigate the effect of pemetrexed on the immune function,quality of life and survival time of patients with malignant pleural effusion.Methods Eighty cases patients with non-small cell lung cancer from July 2013 to October 2015 in the People′s Hospital of Hunan Province were complicated with pleural effusion,and randomly divided into observation group and control group,40 cases in each group.The control group were used chemotherapy with GP(gemcitabine plus cisplatin) and the central venous catheter was placed in the thoracic cavity.The observation group was treated with retrograde injection of pemetrexed catheter on the basis of the control group.The changes of immunoglobulin and inflammatory cytokines were compared between the two groups,and the quality of life and the 1 year survival rate of the two groups were statistically analyzed.Results The IgM,IgG and IgA of the observation group after the intervention were higher than those in control group((1.65±0.03) mg/L vs.(1.31±0.02) mg/L,(9.55±0.12) mg/L vs.(8.82±0.10) mg/L,(3.99±0.20) mg/L vs.(1.81±0.13) mg/L,t=59.640,29.557,57.800,P<0.05),the TNFα-,IL-1,hs-CRP levels of the observation group after the intervention were lower than the control group((12.0±0.2) μg/L vs.(18.1±0.5) μg/L,(0.60±0.1) mg/L vs.(0.92±0.2) mg/L,(10.3±1.0) mg/L vs.(31.3±2.0) mg/L,t=71.641,9.051,59.397,P<0.05),and quality of life score after the intervention than before((81.5±2.3) points vs.(81.6±2.3) points,(35.3±1.1) points vs.(56.6±1.7) points,t=114.608,55.823,P<0.05).Quality of life of the observation group was better than the control group(t=66.530,P<0.01),1 year survival rate was higher than the control group(25.0%(10/40) vs.50.0%(20/40),U=5.903,P<0.05).Conclusion Local chemotherapy with pemetrexed could significantly improve the immune function of patients with malignant pleural effusion,reduce the inflammatory response,improve the quality of life and prolong the survival time of patients with malignant pleural effusion.