结直肠癌化疗期间PEG-rhG-CSF对中性粒细胞增殖率及化疗不良反应的影响

Effects of PEG-rhG-CSF on the proliferation rate of neutrophils and chemotherapy-induced ARs during chemotherapy for colorectal cancer

目的探讨结直肠癌化疗期间聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)对中性粒细胞增殖率及化疗不良反应的影响。方法选取2018年1月至2021年4月广东省农垦中心医院收治的接受化疗的结直肠癌患者80例,以随机数表法分为对照组(n=40)与观察组(n=40)。对照组采用重组人粒细胞集落刺激因子(rhG-CSF)每日皮下注射,治疗14 d,或中性粒细胞绝对值≥5×109/L时停止用药,观察组化疗结束后采用PEG-rhG-CSF单次皮下注射,比较两组Ⅲ度以上中性粒细胞减少率、再住院率、中性粒细胞减少持续时间、发热性中性粒细胞缺乏症发生率、静脉抗菌药物应用率,治疗24、48、96 h的中性粒细胞数、中性粒细胞增殖率与不良反应发生率。结果观察组Ⅲ度以上中性粒细胞减少率、再住院率均低于对照组,差异有统计学意义(P<0.05);两组中性粒细胞减少持续时间、发热性中性粒细胞缺乏症发生率、静脉抗菌药物应用率比较,差异无统计学意义(P>0.05);观察组治疗24、48、96 h的中性粒细胞数高于对照组,治疗24、48、96 h的中性粒细胞增殖率高于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论PEG-rhG-CSF可有效促进结直肠癌患者化疗后中性粒细胞增殖,预防中性粒细胞减少的发生,使化疗毒副反应减轻。

Objective To investigate the effects of polyethylene glycol recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)on the proliferation rate of neutrophils and chemotherapy-induced adverse reactions(ARs)during chemotherapy for colorectal cancer.Methods A total of 80 patients with colorectal cancer admitted to Guangdong Agricultural Reclamation Central Hospital for chemotherapy from January 2018 to April 2021 were selected and divided into the control group(n=40)and the observation group(n=40)according to the random number table method.The control group was subcutaneously injected with rhG-CSF daily until the 14th d of treatment or when the absolute neutrophil count was≥5×109/L,while the observation group was subcutaneously injected with PEG-rhG-CSF once only at the end of chemotherapy.The rate of GradeⅢor above neutropenia,re-hospitalization rate,duration of neutropenia,incidence of febrile neutrophil deficiency,application rate of antibacterial drugs via venas,neutrophil count and proliferation rate of neutrophils at 24,48,96 h of treatment,and the incidence of ARs were compared between the two groups.Results The rate of GradeⅢor above neutropenia and re-hospitalization rate in the control group were lower than those in the observation group,with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in the duration of neutropenia,the incidence of febrile neutrophil deficiency and the application rate of antimicrobial drugs via venas(P>0.05).The neutrophil counts were higher at 24,48,96 h of treatment,and the proliferation rates of neutrophils were higher at 24,48,96 h of treatment in the observation group than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference between the two groups in the total incidence of ARs(P>0.05).Conclusion PEG-rhG-CSF can effectively promote neutrophil proliferation,prevent the occurrence of neutropenia and reduce the toxicity of chemotherapy for patients in the treatment of colorectal cancer.