肿瘤患者化疗相关性贫血的治疗

Treatment of Chemotherapy-related Anemia in Cancer Patients

目的研究我科肿瘤患者贫血的发生情况及化疗相关性贫血的药物干预治疗,及对癌因性疲劳及生活质量的影响。方法收集我科2007年8月～2008年11月肿瘤患者的病例资料,统计贫血的发生率,贫血的程度,与化疗的关系等,对于化疗相关性贫血患者,给予皮下注射重组人红细胞生成素注射液或合并静脉补充铁剂,8周后复查血常规,评价治疗效果并比较治疗前后对癌因性疲劳及生活质量的影响。结果 84例肿瘤患者贫血的发生率为83.33%,其中轻度贫血26人(30.95%),中度贫血26人(30.95%),重度贫血13人(15.48%),危及生命的贫血5人(5.95%),无贫血14人(16.67%),对于化疗相关性贫血患者经治疗后血红蛋白平均升高(21.2±3.3)g/L。皮下注射重组人红细胞生成素注射液合并静脉补充铁剂组血红蛋白增高与单纯皮下注射重组人红细胞生成素注射液组比较有统计学意义。治疗前后疲劳症状量表及生活质量自评量表表明患者癌因性疲劳及生活质量明显改善。结论肿瘤患者合并贫血发生率高,尤其合并化疗者,严重影响患者生活质量,及时发现并纠正化疗相关性贫血能明显改善患者的生存质量,皮下注射重组人红细胞生成素注射液合并静脉补充铁剂能有效改善化疗相关性贫血。

Objective To explore the anemia incidence of cancer patients in our department and the treatment of chemotherapy-related anemia.Cancer-related fatigue and quality of life were evaluated before and after treatment.Methods The clinical data of 84 patients who had been treated in out department between Aug 2007 and Nov 2008 were collected.The incidence and degree of anemia were evaluated,and the relationship between chemotherapy.EPO or combined with iron agent.Results The incidence of anemia was 83.33%,mild anemia was recorded as 30.95%,moderate anemia was 30.95%,and severe anemia was 15.48%,life-threatening anemia was 5.95%.None anemia was 16.67%.Hemoglobin level were elevated（21.2±3.3）g/L on average.EPO accompanied by intravenous iron supplementation significantly increase in hemoglobin compared with no iron.Brief Fatigue Inventory（BFI）and Functional Assessment of Cancer Therapy-General（FACT-G）showed that cancer-related fatigue and quality of life were improved obviously.Conclusion The anemia incidence in cancer patients is high,especially accompanied by chemotherapy.Anemia correlated significantly with the quality of life.Early intervention in anemia had clinical significance in cancer patients.Addition of intravenous iron to EPO increases hemoglobin response.