促红素治疗恶性肿瘤化疗相关性贫血的最佳剂量及疗效的探讨

The study of optimal dose and efficacy of erythropoietin treatment of patients with chemotherapy-related anemia

目的对促红素（RHEpo）治疗恶性肿瘤化疗相关性贫血的最佳剂量及疗效进行初步探讨。方法将符合条件的145例化疗相关性贫血患者随机分为RHEpo20000U组、RHEpo30000U组、RHEpo40000U组、RHEpo50000U组、RHEpo60000U组和安慰剂组，所有患者均同步进行顺铂为主的化疗，并连续观察8周，每2周进行一次RHEpo的疗效比较。结果@RHEpo20000U组的有效率低于其他各RHEpo组（P〈0．05或P〈0．01）；@RHEpo30000U组与高于其剂量的各RHEpo组在显效时间、升高血红蛋白值、提高生活质量、降低输血需求率、不良反应发生率以及有效率方面均无统计学差异（均P〉0．05）。结论①RHEpo有预防和治疗恶性肿瘤化疗相关性贫血的作用；（2）RHEp020000U组治疗化疗相关性贫血的疗效低于其他各RHEpo组（30000u～60000U），而在RHEpo30000U—RHEpo60000U的剂量范围内，RHEpo的疗效未发现随剂量的增加而明显增高，因此建议将RHEpo30000U作为适合国人的最佳剂量试用于临床；（3）RHEpo治疗化疗相关性贫血可能存在着种族差异。

Objective To study the optimal dose and efficacy of erythropoietin treatment of patients with chemotherapy-related anemia. Methods 145 cases of chemotherapy-related anemia were randomly divided into RHEpo 20000 U group, RHEpo 30000 U group, RHEpo 40000 U group, RHEpo 50000 U group, RHEpo 60000 U group and the placebo group, all patients were carried out simultaneously with cisplatin-based chemotherapy, and continuous observation for 8 weeks, once every 2 weeks compared the efficacy of RHEpo. Results RHEpo 20000 U groups were less efficient than other RHEpo group（ P 〈 0.05 or P 〈 0. 01 ）. RHEpo 30000 U group and higher than the onset time of RHEpo group had no statistically significant difference in such things as improvement of hemoglobin level and KPS,reducing the rate of blood transfusion requirements, adverse reaction rates and effect rate. Conclusion （1）RHEpo could prevent and treat chemotherapy-related anemia. （2）The efficiency of RHEpo 20000 U group treatment of chemotherapy-related anemia is less than other RHEpo group（ 30 000 - 60 000 U）. While in the dose range from RHEpo 30 000 U to RHEpo 6 0000 U, RHEpo efficacy was found no improvement with dose increasing,it is proposed RHEpo 30000 U as the best dose for people in clinical trials. （3）Racial variations probably play a role on clinical effect of RHEpo treatment of chemotherapy-related anemia.