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PEG-rhG-CSF一级预防化疗中性粒细胞减少的临床观察 被引量:3

Clinical observation on neutropenia primary prevention with pegylated recombinant human granulocyte colony stimulating factor after chemotherapy
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摘要 目的分析化疗后中性粒细胞计数减少的影响因素,对比聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)和重组人粒细胞集落刺激因子(rhG-CSF)的临床疗效,观察PEG-rhG-CSF对化疗后中性粒细胞绝对值(ANC)减少的一级预防效果和安全性。方法选择2019年7月—2020年6月本院收治的接受高危FN(febrile neutropenia,FN)风险方案和中危FN风险方案化疗并伴≥1个风险因素患者60例作为研究对象,按照随机数表法分为观察组和对照组两组,每组各30例。在接受第1个周期化疗48 h后,观察组给予PEG-rhG-CSF 6 mg皮下注射,立即;对照组给予rhG-CSF 3μg/kg皮下注射,每日一次;至复查血常规WBC≥10.0×10^(9)/L或ANC≥5.0×10^(9)/L停药。结果经单因素分析年龄(t=-4.156,P=0.000)、血肌酐值(t=-2.266,P=0.027)、白蛋白(t=2.017,P=0.048)影响因素(P<0.05),再将这三项进行logistic回归多因素分析,年龄(P=0.009)为影响因素;观察组和对照组预防性升白细胞后第9天(t=2.693,P=0.012)、第18天(t=2.951,P=0.006)ANC差异有统计学意义;两组的不良反应表现在骨痛、发热、乏力,发生率对比无差异(P>0.05)。结论年龄的增加是影响化疗后中性粒细胞减少的危险因素。在化疗后中性粒细胞减少的一级预防中PEG-rhG-CSF效果与rhG-CSF相当,其半衰期长,血药浓度更加稳定;PEG-rhG-CSF的常见不良发生率与rhG-CSF相比未见增加。 Objective This study analyzed the influencing factors for decrease in neutrophil granulocyte after a chemotherapy treatment,compared the clinical efficacy of pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF)and recombinant human granulocyte colony stimulating factor(rhG-CSF),and displayed the prevention effect and safety of PEG-rhG-CSF on the decrease neutrophil granulocyte after treated by chemotherapy.Methods From July 2019 to June 2020,60 patients received chemotherapy with high-risk febrile neutropenia(FN)scheme and medium risk FN scheme and combined with more than one risk factors were enrolled as study subjects,and they were randomly divided into observation group and control group according to the number table method,30 cases in each group.After receiving chemotherapy 48 h in the first cycle,the observation group immediately subcutaneous injected with PEG-rhG-CSF at dose of 6mg.The control group was subcutaneous injected with rhG-CSF at dose of 3μg/kg once a day,and stopped after the blood routine reached WBC≥10.0x10^(9)/L or ANC≥5.0x10^(9)/L.Results Univariate analysis result indicated that the differences in age(t=-4.156,P=0.000),blood creatinine(t=-2.266,P=0.027),and albumin(t=2.017,P=0.048)were influencing factors(P<0.05).These three positive indicators were included in the logistic regression multivariate analysis,and the result suggested that age(P=0.009)was the influencing factor.The difference in ANC between the observation group and the control group on the 9th(t=2.693,P=0.012)and 18th day(t=2.951,P0.006)after treatment was statistically significant.The adverse reactions of the two groups were bone pain,fever,fatigue,however,there was no difference in the incidence rate(P>0.05).Conclusions Increasing age is a risk factor affecting neutropenia after chemotherapy.The use of PEG-rhG-CSF as a primary prevention of neutropenia after chemotherapy has the same effect as rhG-CSF,and has a longer half-life,more stable blood concentration.The common adverse reactions of PEG
作者 何杨 朱益平 彭玉珍 罗永红 HE Yang(Oncology department,the first affiliated hospital of Wannan Medical college,Wuhu,Anhui,241001,China)
出处 《齐齐哈尔医学院学报》 2021年第10期873-876,共4页 Journal of Qiqihar Medical University
基金 安徽省高等学校自然科学研究项目(KJ2017A265)。
关键词 聚乙二醇化重组人粒细胞刺激因子 一级预防 化疗 中性粒细胞减少 Pegylated recombinant human granulocyte colony stimulating factor Primary prevention Chemotherapy Neutropenia
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