PEG-rhG-CSF对Ⅲ度中性粒细胞减少患者粒细胞增殖状况的研究

Effect of pegylated recombinant human granulocyte colony stimulating factor on neutrophil proliferation in patients with degree Ⅲ neutropenia

目的：探讨聚乙二醇化重组人粒细胞刺激因子（PEG-rhG-CSF）对同期放化疗所致Ⅲ度中性粒细胞减少患者的粒细胞增殖作用，为其临床应用提供依据。方法：对105例同步放化疗所致Ⅲ度中性粒细胞减少的恶性肿瘤患者进行分析，试验组包括：P-50组、P-100组、P＋R组，其中P-50组38例为PEG-rhG-CSF50μg·kg^-1单次皮下注射；P-100组26例为100μg·kg^-1单次皮下注射；P＋R组21例为PEG-rhG-CSF50μg·kg^-1单次皮下注射＋rhG-CSF5μg·kg^-1·d^-1皮下注射，外周血中性粒细胞绝对计数（ANC）≥2．0×10^9·L^-1后停用rhG-CSF；对照组为Rc组20例，即rhG-CSF5μg·kg^-1·d^-皮下注射，ANC≥2．0×10^9·L^-1后停用。对上述各组患者的时间-中性粒细胞增殖率、时间-ANC值进行统计学分析。结果：试验组的时间-中性粒细胞增殖率和时间．ANC值均显著高于对照组，各试验亚组的临床效应发挥均始于用药12～24h，于24h左右达到改善粒细胞减少的治疗目的，P-50组与P＋R组的时间-中性粒细胞增殖率和时间-ANC值无明显差异。结论：PEG-rhG-CSF对于治疗同期放化疗后Ⅲ度中性粒细胞减少患者的粒细胞具有较好的增殖作用，对于同期放化疗所致Ⅲ度中性粒细胞患者的推荐剂量为单次50μg·kg^-1皮下注射。

Objective： To investigate the effect of pegylated recombinant human granulocyte colony stimu- lating factor （PEG-rhG-CSF） on neutrophil proliferation in patients with degree Ⅲ neutropenia induced by synchro- nized radiotherapy and chemotherapy, for providing evidence for rational application of PEG-rhG-CSF. Methods： Totally 105 cancer patients with degree Ⅲ neutropenia induced by synchronized radiotherapy and chemotherapy were analyzed. They were divided into three subsections, and treated with a single injection of PEG-rhG-CSF 50 μg.kg^-1 （P-50, n=38）, a single injection of PEG-rhG-CSF 100 μg.kg^-1（P-100, n =26）, and a single injec- tion of PEG-rhG-CSF 50 μg.kg^-1 plus multiple injections of rhG-CSF 5 μg.kg^-1.d^-1 （ P ＋ R, n =21 ） until the ab- solute neutrophil count （ANC） reached to ≥2.0 × 10^9. L-1. The patients in control group （RC, n = 20） receivedhours, and neutropenia was improved in 24 hours. There was no significant difference between P-50 and P ＋ R groups in neutrophil growth rate and ANC. Conclusion： PEG-rhG-CSF is effective on neutrophil proliferation, and the recommended dose of PEG-rhG-CSF is 50 μg. kg^-1 for the treatment of degree Ⅲ neutropenia induced by syn- chronized radiotherapy and chemotherapy.