不同剂量rhG-CSF对急性白血病患者化疗后白细胞水平的影响

Effects of different doses of rhG-CSF on the white blood cell in patients with acute leukemia after chemotherapy

目的探讨不同剂量重组人粒细胞集落刺激因子(rhG-CSF)对急性白血病患者化疗后白细胞水平的影响。方法选择2014年1月至2017年5月该院收治的64例急性白血病患者为研究对象,根据入院先后顺序随机分为3组,rhG-CSF用量每天为400μg/m^2(高剂量)设为A组,rhG-CSF用量每天为300μg/m^2(中剂量)设为B组,rhG-CSF用量每天为200μg/m^2(低剂量)设为C组,疗程3d。比较3组患者化疗后白细胞最低值(WBC_(min)),最高值(WBC_(max)),白细胞计数(WBC)<4.0×10~9/L的时间即WBC减少时间;并于化疗2周期后使用KPS评分评定患者生存质量,记录应用抗菌药物情况。结果化疗后,3组患者WBC_(min)及WBC_(max)差异无统计学意义(P>0.05);WBC减少时间在A组为(1.73±0.48)d,明显低于B组[(3.35±1.29)d],B组低于C组[(5.84±2.62)d],差异均有统计学意义(P<0.05);3组患者KPS评分比较差异无统计学意义(P>0.05);C组抗菌药物使用率(33.33%)明显高于A组(5.56%)和B组(11.11%),差异均有统计学意义(P<0.05),但是B组与C组间抗菌药物使用率比较,差异无统计学意义(P>0.05)。结论中、高剂量的rhG-CSF可以有效缩短急性白血病化疗患者的白细胞减少期,且中剂量与高等剂量rhG-CSF的治疗效果相当,更值得临床推荐。

Objective To investigate the effect of different doses of recombinant human granulocyte colony-stimulating factor(rhG-CSF)on the white blood cells in patients with acute leukemia after chemotherapy.Methods From January 2014 to May 2017,64 cases of acute leukemia patients in our hospital as the research object,according to the order of admission were randomly divided into 3 groups,the dosage of rhG-CSF in A group(high dose)of 400μg/(m 2·d),B group(middle dose)for 300μg/(m 2·d),C group(low dose)for 200μg/(m 2·d),course of 3 days.The 3 groups after chemotherapy were compared with minimum value of white blood cells(WBC min),the highest value(WBC max),WBC reduce time;and after 2 cycles of chemotherapy using KPS score to evaluate the survival quality of patients,record the application of antibiotics.Results After chemotherapy,there were of no significant difference between the 3 groups in WBC min and WBC max(P>0.05);WBC reduce the time in A group was(1.73±0.48)d,significantly lower than that of group B[(3.35±1.29)d],B group was lower than that of C group[(5.84±2.62)d],the difference was of statistically significant(P<0.05);there was of no significant difference in KPS scores between 3 groups(P>0.05);the antibiotic use rate of group C(33.33%)was significantly higher than that of group A(5.56%)and group B(11.11%)(P<0.05);but the B group and C group was of no statistical significance difference(P>0.05).Conclusion Middle and high dose of rhG-CSF can effectively shorten the period of white blood cell reduction in patients with acute leukemia chemotherapy,and the therapeutic effect of medium dose and higher dose of rhG-CSF is equivalent,which is more worthy of clinical recommendation.