G-CSF与GM-CSF联合用药治疗化疗后骨髓抑制的比较

Comparison between Combination of G-CSF and GM-CSF in Patients With Arrest of Bone Marrow Caused by Chemotherapy

目的了解联合应用G-CSF和GM-CSF治疗Ⅱ度及以上化疗后骨髓抑制的可行性和安全性以及不良反应。方法84例确诊的恶性肿瘤化疗后出现Ⅱ度及以上骨髓抑制的患者,随机单盲分为G-CSF组(G组:n=28,G-CSF150μg/d皮下注射),GM-CSF组(GM组:n=28,GM-CSF150μg/d皮下注射),联合用药组(G/GM组:n=28,G-CSF75μg/d和GM-CSF75μg/d皮下注射)。观察:(1)用CSF后WBC恢复正常所需天数;(2)停用CSF48h后WBC计数;(3)停用CSF48h后PLT计数;(4)不良反应发生率。结果三组患者用药后均能有效提升白细胞。在WBC恢复正常天数上GM组明显长于G组和G/GM组(P<0.05);停药48h后WBC计数GM组和G/GM组明显高于G组(P<0.05);停用CSF48h后PLT计数GM组和G/GM组明显高于G组(P<0.05)。三组不良反应发生率接近,组间比较无显著性差异。结论G-CSF和GM-CSF联合用药能安全、有效地治疗化疗后骨髓抑制,可避免单独用药的弊端,是化疗后骨髓抑制的有效治疗方法。

Objective To investigate the safety, feasibility and adverse reaction of combination of G-CSF and GM-CSF in patients with Ⅱ degree and above arrest of bone marrow caused by chemotherapy. Methotis 84 patients with definite malignant tumor and Ⅱ degree and above arrest of bone marrow caused by chemotherapy were enrolled into a single-blinded and random study： G-CSF group （G group, n = 28, G- CSF 150 μg/d subcutaneous injection）, GM-CSF： group（GM group., n = 28, GM-CSF 150 μg/d subcutaneous injection）,combination drugs group（G/GM group,n = 28,G-CSF 75 μg/d and GM-CSF 75 μg/d subcutaneous injection）. Observation items： （1）the days of WBC normalization after CSF application; （2）WBC count after 48 hours withdrawal of CSF; （3） PLT count after 48 hours withdrawal of CSF; （4） incidence rate of adverse reaction. Results Leukcocyte count in three groups increased. The days of WBC normalization inGM group were longer than that in G group and G/GM group （P〈0. 05）. WBC count after 48 hours withdrawal of CSF in GM group and G/GM group was obviously more than that in G group （P〈0. 05）. Incidence rate of adverse reaction in three groups was approximate and there was no significant difference between groups. Conclusion Combination of G-CSF and GM-CSF was an effective and safe treatment to be applied in patients with arrest of bone marrow caused by chemotherapy, and it could reduce the defect of single application.