摘要目的:探讨重组改构人肿瘤坏死因子(rmhTNF)治疗肺癌恶性胸腔积液的效果及安全性。方法:选取2017年1月至2020年1月山西省煤炭中心医院血液肿瘤科收治的62例肺癌恶性胸腔积液患者，男33例，女29例，年龄(71.5±4.3)岁，年龄范围为65～90岁。采用随机数表法将患者随机分为顺铂组及rmhTNF组，每组31例，顺铂组采用顺铂治疗，rmhTNF组在顺铂组的基础上加用rmhTNF治疗，比较治疗4周后两组患者的治疗效果、治疗后生活质量、不良反应发生情况及生存期。结果:rmhTNF组患者的缓解率[74.2%(23/31)]高于顺铂组[42.0%(13/31)]，总生活质量[(70.56±6.71)分]优于顺铂组[(60.38±5.98)分]，差异有统计学意义( P<0.05)。rmhTNF组患者出现4例不良反应，顺铂组出现6例不良反应。rmhTNF组患者无进展生存期、总生存期均长于顺铂组，差异有统计学意义( P<0.05)。 结论:rmhTNF治疗肺癌恶性胸腔积液的缓解率高，生活质量好，值得在临床上推广应用。

abstractsObjective:To analyze the efficacy and safety of recombinant mutant human tumor necrosis factor(rmhTNF)for malignant pleural effusion of lung cancer.Methods:A total of 62 patients with lung cancer and malignant pleural effusion treated in the department of Hematology and oncology of Shanxi coal Central Hospital from January 2017 to January 2020 were selected, including 33 males and 29 females, aged(71.5±4.3 )years, ranging from 65 to 90 years.The patients were randomly divided into cisplatin group and rmhTNF group with 31 cases in each group.The cisplatin group was treated with cisplatin, and the rmhTNF group was treated with rmhTNF on the basis of cisplatin group.The treatment effect, quality of life after treatment, occurrence of adverse reactions and survival time of the two groups were compared after 4 weeks of treatment.Results:The remission rate[74.2%(23/31)]in rmhTNF group was higher than that in cisplatin group[42.0%(13/31)], and the total quality of life[(70.56±6.71)scores]was better than that in cisplatin goup[(60.38±5.98)scores], the difference was statistically significant( P<0.05). There were 4 adverse reactions in rmhTNF group and 6 adverse reactions in cisplatin group.The progression free survival and overall survival in rmhTNF group were longer than those in cisplatin group( P<0.05). Conclusion:rmhTNF is effective in treating malignant pleural effusion of lung cancer and is worthy of popularization and application.