【摘要】 目的探讨不同剂量聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)对同步放化疗所致Ⅳ度骨髓抑制患者中性粒细胞增殖的影响,为其临床应用提供依据。方法对114例同期放化疗所致Ⅳ度骨髓抑制的恶性肿瘤患者进行分析,试验组包括P-50组、P-100组和P+R组,其中P-50组42例,单次皮下注射PEG-rhG-CSF 50μg·kg-1;P-100组30例,单次皮下注射PEG-rhG-CSF 100μg·kg-1;P+R组22例,单次皮下注射PEG-rhG-CSF 50μg·kg-1+皮下注射rhG-CSF 5μg·kg-1·d-1,外周血中性粒细胞绝对计数(ANC)≥2.0×109·L-1后停用rhG-CSF;对照组为RC组20例,皮下注射rhG-CSF 5μg·kg-1·d-1,ANC≥2.0×109·L-1后停用。对上述各组患者的时间-中性粒细胞增殖率、时间-ANC值进行统计学分析。结果试验组的时间-中性粒细胞增殖率和时间-ANC值均显著高于对照组,试验组的临床效应发挥始于用药12~24 h,于36 h左右达到改善中性粒细胞缺乏的治疗目的,P-50组与P+R组的时间-中性粒细胞增殖率和时间-ANC值无明显差异。结论 PEG-rhG-CSF对于治疗同期放化疗后Ⅳ度骨髓抑制的中性粒细胞缺乏具有较好的增殖作用,对于同期放化疗所致Ⅳ度粒骨髓抑制患者单次50μg·kg-1皮下注射的增殖效应即可满足临床要求。更多还原

【Abstract】 AIM To investigate the neutrophil proliferation efficacy of different doses of pegylated recombinant human granulocyte colony stimulating factor( PEG-rhG-CSF) for the Ⅳ degree bone marrow suppression neutropenia induced by concurrent chemoradiotherapy,then provide evidence for the appropriate application of PEG-rhG-CSF in clinical.METHODS Study the Ⅳ degree myelosuppression caused by concurrent chemoradiotherapy in 114 malignant tumor patients.There were three subsections in trail group:(1) Group P-50,forty-two patients received a single subcutaneous injection of PEG-rhG-CSF 50 μg·kg-1;(2) Group P-100,thirty patients received a single subcutaneous injection of PEG-rhG-CSF 100 μg·kg-1;(3) Group P + R,twenty-two patients received a single subcutaneous injection of PEG-rhG-CSF 50 μg·kg-1and multiple subcutaneous injections of rhG-CSF 5 μg·kg-1·d-1,until the absolute neutrophil count(ANC) ≥2.0 × 109·L-1.The control group was defined with RC,in this group twenty patients received multiple subcutaneous injections of rhG-CSF 5 μg·kg-1·d-1,untill ANC ≥ 2.0 × 109·L-1.Analyze the time-neutrophil growth rate and the time-ANC induced by above drugs.RESULTS The experimental group was obviously higher than the control group in the aspect of the time-neutrophil growth rate and the time-ANC.In the experimental group the period of the clinical effect began in 12-24 hour,and the conditions of neutropenia improved in 36 hours.There was no statistical significance between the P-50 and P + R in the aspect of the time-neutrophil growth rate and the time-ANC.CONCLUSION PEG-rhG-CSF has well neutrophil proliferation effect,to the forth degree myelosuppression induced by concurrent chemoradiotherapy patient,the dose of PEG-rhG-CSF50 μg·kg-1is enough.更多还原