粒细胞集落刺激因子对肿瘤化疗患者白细胞数及医院感染的影响

Effects of granulocyte colony stimulating factor on white blood cell count and nosocomial infection in malignant tumor patients after chemotherapy

目的探讨粒细胞集落刺激因子对肿瘤患者化疗后血白细胞数变化及感染危险性的影响。方法初次化疗后血白细胞降低的恶性肿瘤患者,于第2、3周期分别采用预防性或治疗性粒细胞集落刺激因子进行治疗,观察患者血白细胞数变化规律及医院感染情况。结果观察214例肿瘤化疗患者,血白细胞降低103例(下降发生率48.1%),后者医院感染率15.9%;预防性或治疗性使用粒细胞集落刺激因子均可使白细胞下降持续时间明显缩短、下降程度减轻,且前者效果明显优于后者;两种用药方法均可使Ⅱ、Ⅲ度白细胞降低患者医院感染率明显降低,而对Ⅰ、Ⅳ度降低患者作用不明显。结论肿瘤化疗患者医院感染与血白细胞降低程度密切相关;合理使用粒细胞集落刺激因子可有效减轻骨髓抑制程度,减少医院感染发生,保证化疗顺利完成。

Objective To explore the effects of granulocyte colony stimulating factor on the change of white blood cell count and nosocomial infection in malignant tumor patients after chemotherapy. Methods The malignant tumor patients whose white blood cells decreases after their first chemotherapy were selected. They were treated preventively or remedially with granulocyte colony stimulating factor at the second and third cycle. The changes of white blood cell count and nosocomial infection in the patients were observed. Results In the 214 patients selected, there was decrease in white blood cell count in 103 of them （ an inci- dence rate of 48, 1% ）, the rate of nosocomial infection was 15.9%. Both preventive and remedial use of granulocyte colony stimulating factor could reduce the duration and extent of decrease in white blood cell count, and with the former more effective than the latter; both methods could reduce greatly the rate of nosocomial infection in the patients with a low white blood cell count of degree Ⅱ and Ⅲ, while no obvious effects on patients with low white blood cell count of degree ｜ and IV were observed. Conclusions The nosocomial infection in tumor patients is closely related to the degree of decrease in white blood cell count ; appropriate use of granulocyte colony stimulating factor can reduce the supression of marrow and nosocomial infection, and help the chemotherapy to be finished successfully.