摘要
目的:多发性骨髓瘤(Multiple Myeloma,MM)患者约有80%伴有贫血,临床上多数患者以输血方式纠正贫血。重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)用于治疗MM患者的贫血尽管有效,但以何等剂量、应用多长时间疗效较佳尚无定论。目的:观察持续使用大剂量rHuEPO对MM患者贫血的纠正作用及效果。方法:87例诊断明确的多发性骨髓瘤伴有贫血的患者,开始连续每天使用重组人促红细胞生成素4万单位,皮下注射,共5d;以后每周使用一次,每次4万单位皮下注射,间断补充铁剂。对照组90例选自同期住院的诊断明确的多发性骨髓瘤患者,当其贫血症状明显时或血红蛋白水平低于60g/L时,给予输血纠正其贫血,使多数患者血红蛋白水平维持在80g/L～100g/L以上。两组患者化疗方案不做特殊规定,整过研究观察期6月。结果:rHuEPO组在使用rHuEPO后2周其血红蛋白开始上升,中位反应时间16d;1月半至2月血红蛋白可升至正常水平,达正常血红蛋白水平的中位时间51d。进入研究后3月和6月时,rHuEPO组生活幸福感指数(INLH)明显优于输血组,分别为69.27±3.18(P<0.05)和72.16±2.83(P<0.01)与58.35±2.89和57.76±3.24。6月后,rHuEPO组平均每例直接费用成本10754.40元,明显低于输血组需要达到同样效果所需的每例20704.20元。结论:大剂量rHuEPO治疗MM相关性贫血优于输血,其起效快、疗效好,患者生活幸福感改善明显,费用成本低,安全性较好。
Objective： Anemia is a common complication in patients with multiple myeloma （MM） and occurs in more than two thirds of all patients. Red blood cell （RBC） transfusions is usually administrated clinically. Although recombinant human erythropoietin （rHuEPO） has showed the effectiveness in MM patients with anemia, there is no conclusion in the administration dosage and continuing time. To observe the effects of high dose rHuEPO on MM patients with anemia. Methods： Eightyseven cases who were diagnosed as MM with anemia, were initially given rHuEPO at 40 000 U subcutaneously per day for five days and then at 40 000 U per week. Meanwhile,one kind of chalyheate was administrated interruptablly. 90 controls who were selected from hospitalized MM patients during the same month, received blood transfusion when their hemoglobin（Hb） levels were lower than 60 g/L or they have manifestated a significant anemic symptoms so as to keep the Hb levels of most controls more than 80 g/L-100 g/L. At the same time, the chemotherapy schemes for the two groups were not limited. The observed period is six months. Results： For the case group（rHuEPO group）, Hb levels began to elevate at 2 weeks and the median response time is 16 days;those Hb levels could achieve normal level during 1.5 and 2 months and the median time is 51 days after rHuEPO has been used. The index number of living happiness（INLH） for rHuEPO group is significantly better than that of control group （transfusion group） ： 69. 27±3.18 vs 58. 35±2.89（P〈0. 05） and 72.16±2.83 vs 57.76±3.24 （P〈0. 01） respectively at three and six months after entering research. At the research endpoint, the average direct cost of rHuEPO group for each case is 10 754. 40 RMB, which is obviously less than 20 704.20 RMB of transfusions group at the same effectiveness. Conclusion; The high dose rHuEPO displayed the better effects, the fewer response time, the more significant improvement of INLH and the lower cost than blood transfusion on MM patien
出处
《华西医学》
CAS
2009年第5期1147-1149,共3页
West China Medical Journal
