重组粒细胞集落刺激因子在再生障碍性贫血中的应用

Application of recombinant human granulocyte colony stimulating factor in the treatment of aplastic anemia

目的探讨重组人粒细胞集落刺激因子(rh G-CSF)对再生障碍性贫血治疗的可行性。方法选取2012年6月至2013年12月收治的再生障碍性贫血患者51例,随机分为观察组26例和对照组25例。对照组采用常规综合疗法治疗,观察组在常规综合疗法的基础上加用rh G-CSF皮下注射(5μg/kg,qd),疗程3个月。结果治疗后两组患者外周血白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)均较治疗前升高,CD3+、CD4+、CD8+均较治疗前下降(P均<0.05);观察组各项指标改善均显著优于对照组(P均<0.05)。治疗后,两组患者粒系增生程度及巨核细胞个数均较治疗前明显增加(P均<0.05),且观察组各指标及骨髓增生活跃率均明显高于对照组(P均<0.05)。观察组感染发生率、感染次数及抗生素应用天数均较对照组明显减少(P均<0.05)。结论综合疗法联合rh G-CSF能迅速提高再生障碍性贫血治疗疗效,减少感染发生率,促进患者造血功能恢复。

Objective To investigate the feasibility of recombinant human granulocyte colony stimulating factor（（ rh GCSF）） for treating aplastic anemia. Methods Fifty-one patients with aplastic anemia admitted between June 2012 and December 2013 were selected,and the patients were randomly divided into observation group（ n = 26） and control group（ n =25）. The conventional combining therapy was given in control group,and rh G-CSF（ 5μg / kg,qd） was given by hypodermic injection on the basis of conventional combining therapy in observation group,and the treatment period of both groups were3 months. Results Compared with pre-treatment,peripheral blood leucocyte（ WBC）,hemoglobin（ Hb） and platelet（ PLT）significantly increased,and CD3 ^＋,CD4 ^＋,CD8^ ＋ significantly decreased after treatment in both two groups（ all P〈0. 05）,but the aforementioned indexes after treatment were significantly improved in observation group compared with control group（ all P〈0. 05）. Compared with pre-treatment,the hyperplasia degree of grain department and the number of megakaryocyte after treatment in both two groups significantly increased（ all P〈0. 05）,but the aforementioned indexes and the active rate of bone marrow hyperplasia after treatment in observation group were significantly improved compared with control group（ all P〈0. 05）. The incidence of infection,the number of infection and the course of antibiotics treatment in the observation group decreased significantly compared with control group（ all P〈0. 05）. Conclusions The therapy of rh G-CSF combined with conventional therapy can rapidly increase therapeutic effect,reduce incidence of infection and promote the recovery of hematopoietic function in the treatment of aptastic anemia patients.