探究聚乙二醇化重组人粒细胞集落刺激因子对化疗相关性粒细胞减少骨髓抑制的预防效果

Explore the preventive effect of bone marrow suppression to reduce white Shinri on chemotherapy-induced granulocyte

目的:通过与重组人粒细胞集落刺激因子(rh G-CSF)对比,探究新瑞白(PEG-rh G-CSF)对化疗相关性粒细胞减少的预防效果及安全性。方法:采用自身交叉对照研究方法,100例恶性肿瘤患者均接受两个周期化疗,方案相同。实验周期给予PEG-rh G-CSF 100μg/kg皮下注射,每周期1次,对照周期给予rh G-CSF 5μg/kg皮下注射,每日1次。于2次化疗周期的第3、5、7、9、11、13、17、21 d检测外周血象,记录中性粒细胞绝对计数(ANC)<1.5×109/L和ANC<0.5×109/L发生率,ANC<0.5×109/L持续时间,抗生素使用率和药物相关不良反应发生率。结果:在各化疗周期和总化疗中期中,PEG-rh G-CSF组与rh G-CSF组患者ANC<1.5×109/L发生率、ANC<0.5×109/L发生率、ANC<0.5×109/L持续时间、抗生素使用率方面差异无统计学意义(P>0.05);PEG-rh G-CSF组与rh G-CSF组治疗过程中ANC最低值均出现在化疗第7 d,分别为(6.8+2.4)×109/L和(7.3+3.5)×109/L,差异无统计学意义(t=2.42,P=0.109);PEG-rh G-CSF组与rh G-CSF组药物相关不良反应总发病率分别为26.0%和31.0%,差异无统计学意义(χ2=1.85,P=0.289)。结论:预防性用药时,新瑞白1剂给药与rh G-CSF连续给药效果相当,不良反应少,与rh G-CSF相比半衰期长,血药浓度稳定,是预防恶性肿瘤患者化疗后粒细胞减少的新选择,值得临床推广。

Objective： With recombinant human granulocyte colony stimulating factor（ rh G-CSF） on contrast,white Shinri（ PEG-rh G-CSF） prevention effect and safety to reduce chemotherapy-induced granulocyte. Methods： 100 patients with malignant tumor were treated with two cycles of chemotherapy with the same scheme. The experimental period was given PEG-rh G-CSF 100 μg/kg subcutaneous injection,once a week,the control cycle was given rh G-CSF 5 μg/kg subcutaneous injection,once a day. Results： In each cycle of chemotherapy and chemotherapy in the middle of the total,PEG-rh G-CSF group and rh G-CSF group ANC 1. 5 ×10^9/L incidence,the incidence of ANC 0. 5 ×10^9/L,ANC 0. 5 ×10^9/L duration and antibiotic use was no significant difference（ P〈0. 05）.In group PEG-rh G-CSF and group rh G-CSF,the minimum ANC value in the course of treatment appeared seventh days after chemotherapy,respectively,（ 6. 8 ＋ 2. 4） ×10^9/L and（ 7. 3 ＋ 3. 5） ×10^9/L,the difference was not statistically significant（ t = 2. 42,P = 0. 109）.The total incidence of drug-related adverse reactions in group PEG-rh G-CSF and group rh G-CSF was 26% and 31%,respectively. There was no significant difference between the two groups（ χ^2= 1. 85,P = 0. 289）. Conclusion： Preventive medication,Shinri white 1 dose and rh G-CSF continuous administration of equivalent effect,less adverse reaction,compared with rh G-CSF long half-life,stable blood concentration,is a new choice for prevention of neutropenia in patients with malignant tumors after chemotherapy,it is worthy of clinical promotion.