1.上海交通大学医学院附属新华医院崇明分院 神经内科，上海，202150;2.抚州市第一人民医院，江西 抚州，344000
1.Department of Neurology, Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University;2.School of Medicine, Shanghai, 202150, China;3.Fuzhou First People's Hospital, Fuzhou, 344000, Jiangxi, China
目的 探讨老年脑胶质瘤患者抗血管生成治疗中颅内出血及缺血性卒中的发生情况。方法 按照随机数字表法将纳入的122例老年脑胶质瘤患者随机分为观察组与对照组，各61例，对照组患者给予替莫唑胺治疗，观察组在对照组的基础上联合贝伐珠单抗治疗，两组疗程均为12周。比较两组患者的近期疗效、生存质量改善情况、治疗前后血清血管内皮生长因子（VEGF）和表皮生长因子（EGF）水平变化以及颅脑出血和缺血性卒中的发生情况。结果 观察组总有效率（78.69%）显著高于对照组（63.93%）（P<0.05）。观察组生存质量提高率（70.49%）显著高于对照组（52.46%）（P<0.05）。两组患者治疗后血清VEGF、EGF水平均较治疗前明显降低（P<0.05）；观察组治疗后血清VEGF、EGF水平均显著低于对照组（P<0.05）。观察组颅内出血和缺血性卒中的发生率（6.56%、4.92%）均高于对照组（1.64%、0.00%），但差异无统计学意义（P>0.05）。观察组患者总生存期（OS）和无进展生存期（PFS）均明显长于对照组（P<0.05）。结论 抗血管生成药物贝伐珠单抗治疗老年脑胶质瘤患者的近期疗效良好，可提高患者生存质量，降低血清VEGF、EGF水平，但其颅脑出血和缺血性卒中的发生率较高。
Objective To investigate the incidence of intracranial hemorrhage and ischemic stroke in antiangiogenic drugs treatment of elderly patients with glioma.Methods A total of 122 elderly patients with glioma were randomly divided into observation group (61 cases) and control group (61 cases). The control group was treated with temozolomide and the observation group was treated with bevacizumab on the basis of the control group. The course of treatment was 12 weeks in both groups. The short-term curative effect, the improvement of quality of life, changes in the serum levels of vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF) before and after treatment, and the occurrence of cerebral hemorrhage and ischemic stroke were compared between the two groups.Results The total effective rate of the observation group (78.69%) was significantly higher than that of the control group (63.93%) (P<0.05). The improvement rate of quality of life in the observation group (70.49%) was higher than that of the control group (52.46%) (P<0.05). After treatment, the levels of VEGF and EGF were lower than before treatment in both groups (P<0.05), and they were even lower in the observation group after treatment than in the control group (P<0.05). The incidence rate of intracranial hemorrhage (6.56%) and ischemic stroke (4.92%) were separately higher in the observation group than in the control group (1.64% and 0.00%), but there was no significant difference (P>0.05). The observation group had longer overall survival and progression-free survival than the control group (P<0.05).Conclusion The antiangiogenic drug combined with bevacizumab had a good short-term effect on the elderly patients with glioma. It could improve the quality of life and reduce the serum levels of VEGF and EGF of patients, but it may cause a high incidence of cerebral hemorrhage and ischemic stroke.
张源,施德,梅浪华.122例老年脑胶质瘤患者抗血管生成药物治疗中颅内出血及缺血性卒中发生的临床调查研究★[J].肿瘤药学,2023,13(2):210-213 ( in Chinese)复制