重组人促红细胞生成素治疗肿瘤化疗中贫血的临床研究

Clinical study of the anemic management with rhEPO in malignancy patients receiving chemotherapy

目的:研究重组人促红细胞生成素(rhEPO)对接受化疗的肿瘤患者提升血红蛋白的治疗效果。方法:151例肿瘤化疗患者随机分为三组。常规剂量组:rhEPO10000U/次,皮下注射(s.c.),每周3次,持续8周;冲击治疗组:rhEPO20000U,1次/天,连用2天后,10000U,1次/天,连用6天,随后同常规剂量组;对照组:不给予rhEPO,其他同治疗组。结果:经EPO治疗后,冲击组从第2周开始平均Hb水平较治疗前提高2.6g/L(P=0.000),与常规组相比,第2周时平均Hb水平提高2.9g/L,但无明显统计学差异(P=0.053);而第3、4周冲击组平均Hb水平比常规组分别高3.8g/L和3.4g/L,具有显著性差异(P=0.048、P=0.029);至5、6、7、8周时,冲击组虽然平均Hb水平比常规组高,但两者差异不显著(P>0.05)。冲击组+常规组与对照组相比,从第三周开始平均Hb水平即稳步升高(P<0.01)。结论:rhEPO能有效治疗肿瘤患者化疗中贫血,保障化疗正常进行。冲击疗法与常规疗法相比,能较快地提高化疗中患者Hb水平,但对后期Hb水平两者差异不大。

Objective：To investigate the effect of recombinant human erythropoietin （rhEPO） on the hemoglobin （Hb） levels of anemic malignancy patients receiving chemotherapy. Methods： 151 malignancy patients who received chemotherapy were randomly divided into 3 groups： the common therapy group,received rhEPO 10 000 U three times per week for 8 weeks;the high-dose induction therapy group, received rhEPO 20 000 U s.c. per day on d3-d8,and then rhEPO 10 000 U s.c. three times per week;the control group, received other managements similar to rhEPO therapy. Results：The mean Hb level of the high-dose group increased by 2.6 g/L in two weeks with the therapy of rhEPO （,P = 0.000）, and higher than that of the common therapy group by 2.9 g/L, but there was no statistic significance in Hb between the two groups （P = 0.053）; On the 3rd and 4th week,the mean Hb level of high-dose group reached 3.8 g/L and 3.4 g/L, higher than that of the control group （P = 0.048 and 0.029, respectively） ;the high-dose group, compared with the common group, had a higher level of Hb at the 5 th, 6 th,7 th and 8 th week, although they had no statistic difference in Hb levels（P〉 0.05）. Compared with that of the control group,the mean Hb level of rhEPO therapy group had more steadily increased since the 3rd week（P 〈 0.01 ）. Conclusion：rhEPO can effectively treat the anemic malignancy patients receiving chemotherapy. Compared with the common therapy, the high-dose therapy can more quickly improve the mean Hb level of malignancy patients, but both of them have no significant difference in later period.