非小细胞肺癌化疗后脱氧核苷酸注射液干预对骨髓抑制的临床应用价值的随机对照研究

Randomized controlled trial of clinical application value of myelosuppression treated by deoxynucleotide injection intervention after chemotherapy for non small cell lung cancer

目的探究非小细胞肺癌化疗后采用脱氧核苷酸治疗对骨髓抑制的临床应用价值。方法 47例非小细胞肺癌患者随机分为治疗组26例,对照组21例。均给予化疗,化疗周期内治疗组同时给予脱氧核苷酸注射液联合粒细胞集落刺激因子治疗;对照组仅给予粒细胞集落刺激因子皮下注射。评价化疗后7、21 d的白细胞、血小板、免疫功能、体重、生活质量评分及粒细胞集落刺激因子的不良反应。结果治疗组7 d后WBC计数为(5.6±1.5)×109/L,血小板计数为(84.2±16.2)×109/L,WBC恢复正常人数占92.3%,Ⅲ度+Ⅳ度骨髓抑制发生率为11.5%。对照组分别为(3.2±1.6)×109/L,(68.9±20.2)×109/L,66.7%,57.1%。两组比较差异具有统计学意义(P<0.05)。另外两组治疗14 d后,治疗组CD3+[(68.3±8.1)%VS(54.3±6.5)%],CD4+[(36.2±14.5)%VS(30.5±15.0)%],NK细胞[(34.5±12.8)%VS(27.5±8.9)%],体重增加量[(1.6±0.5)kg VS(-0.5±0.2)kg]水平均高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗过程中,治疗组肌肉疼痛/乏力、肝损伤不良事件发生率均为3.8%,对照组分别为33.3%、38.0%。结论脱氧核苷酸注射液可提高白细胞、血小板水平,提高免疫功能及体重,减少粒细胞集落刺激因子的不良反应。

Objective To explore the clinical application value of myelosuppression treated by deoxynucleotide after chemotherapy for non small cell lung cancer. Methods A total of 47 patients with non small cell lung cancer were randomly divided into treatment group with 26 eases and control group with 21 cases. Both groups received chemotherapy, while the treatment group received treatment deoxynucleotide injection combined with granulocyte colony-stimulating factor, and the control group received granulocyte colony-stimulating factor through subcutaneous injection. The evaluation was made on leukocyte, platelets, immune function, weight, life quality score, and adverse reaction of colony-stimulating factor in 7 d and 21 d after chemotherapy. Results In 7 d after chemotherapy, WBC score in the treatment group was （5.6 ±1.5） × 10^9/L, the platelet count was （84.2 ±16.2） × 10^9/L. Patients with normal WBC accounted for 92.3%, and the incidence of Ⅲ＋Ⅳ myelosuppression was 11.5%. These indexes in the control group were （3.2：1： 1.6）×10^9/L, （68.9 ±20.2）× 10^9/L, 66.7%, and 57.1%. There was statistically significant difference between the two groups （P〈0.05）. In 14 d after treatment, the levels of CD3^＋ [ （68.3 ±8.1）%VS（54.3 ±6.5）% ] , CD4^＋ [ （36.2 ±14.5）%VS（30.5 ±15.0）% ] , NK cells [ （34.5 ±12.8）%VS（27.5 ±8.9）% ] , and increased weight [ （1.6 ＋ 0.5）kgVS（-0.5 ＋ 0.2）kg ] in the treatment group were all higher than in the control group, and the difference had statistical significance （P〈0.05）. The adverse event rates of muscle pain/weakness and liver injury were all 3.8% in the treatment group, while they were 33.3% and 38.0% in the control group. Conclusion Deoxynucleotide injection can raise the levels of leukocyte and platelets, improve immune function and weight, and reduce adverse reactions of granulocyte colonystimulating factor.