促红细胞生成素冲击方法治疗化疗相关贫血的临床研究

New regimen of recombinant human erythropoietin for anemic patients with malignancy with combination chemotherapy

目的比较重组人促红细胞生成素(rhEPO)冲击剂量治疗法与常规剂量治疗法治疗肿瘤化疗相关贫血的疗效。方法根据NCCN《癌症及其治疗相关贫血治疗指南》〔1〕,选择64例恶性肿瘤联合化疗后贫血患者(Hb<11g/L),所有病例均经病理或细胞学检查确诊。分组rhEPO冲击治疗组28例(冲击组)和rhEPO常规治疗组(36例)。冲击组rhEPO20000u,1次/d,连用2d,10000u,1次/d,连用6d,即在8d内共用100000u。随后同常规组。常规组40000u/周,皮下注射(SC)。812周。分别于治疗后第2、4、6、8周评定疗效。结果冲击组和常规组基础Hb水平分别为(90±10)g/L和(93±9)g/L;治疗后2周Hb增涨分别为(18.8±7.9)g/L和(9.2±6.3)g/L;治疗后4周Hb增加分别为(32.7±7.8)g/L和(19.2±7.8)g/L;治疗后6周rhEPOHb增加(38.7±8.8)g/L和(27.2±7.4)g/L,治疗后8周rhEPOHb增加分别为(41.0±8.9)g/L和(29.3±9.9)g/L。冲击剂量组和常规剂量组相比差异有统计学意义(P<0.01)。rhEPO冲击剂量治疗组总有效率为84.4%;常规剂量治疗组总有效率为77.8%,差异有显著统计学意义(P<0.01)。结论rhEPO冲击治疗方法能快速纠正联合方案化疗所致贫血,能为顺利完成化疗提供有力的保障;而且安全能够耐受。

Objective：To investigate the effect of new regimen of recombinant human erythropoietin （rhEPO） for anemic patients with malignancies. Method：64 anemic patients with malignancies on combination chemotherapy were divided into two groups at random： one is with rhEPO in higher initial dose including 28 patients （rhEPO 20 000 u, qd×2, IH; 10000u, qdX6 IH and then 40000 u/w so; another is with rhEPO in routine dosage including 36 patients （40 000u/w, so）. Result：The mean baseline Hb level of the group in higher initial dosing and normal dosing control were （90± 10） g/L and （93±9） g/L respectively; .The mean increasing Hb level of higher initial dose group and normal dose control group were （18.8±7.9） g/L and （9.2±6.3） g/L by week 2; （32.7±7.8） g/L and （19.2±7.7） g/L by week 4; （38.7±8.8） g/L and （27.2±7.4） g/L by week 6; （41.0±8.9） g/L and （29.3±9.9） g/L by week 8. The differences between the two groups were significantly （ P 〈0.01）. The overall response rate of the rhEPO in higher initial dose group in frequency was 84.4% which was significantly higher than that of the rhEPO treatment group in routine dose （77.8%）（ P 〈0.01）. Conclusion：The higher initial dosage regimen on the anemic patients of carcinoma on combination chemotherapy could reverse anemia quickly and was well tolerated.