硫培非格司亭预防肿瘤化疗中性粒细胞减少症的临床治疗研究

Clinical treatment of mecapegfilgrastim to prevent neutropenia in tumor chemotherapy

目的探究肿瘤患者预防性使用硫培非格司亭对化疗引起中性粒细胞减少症的临床治疗有效性和安全性。方法采用回顾性分析,选取2019年1月至2021年1月上海健康医学院附属上海市嘉定区中心医院化疗后预防性使用硫培非格司亭或重组人粒细胞刺激因子(rhG-CSF)的恶性肿瘤患者288例。根据选取升白药物的不同,将入组患者分为使用硫培非格司亭组(试验组,184例)和使用rhG-CSF组(对照组,104例)。收集并记录患者信息,并对结果进行分析。结果试验组化疗后中性粒细胞绝对值(ANC)和白细胞计数(WBC)降到正常值范围以下天数及化疗后ANC和WBC恢复到到正常值范围所需天数均少于对照组(P<0.05),试验组ANC和WBC恢复到正常值范围后的维持天数多于对照组(P<0.05)。试验组和对照组骨髓抑制发生率比较差异无统计学意义(P>0.05),但对照组发热性中性粒细胞减少症发生率高于试验组(P<0.05)。试验组不良反应总发生率低于对照组(P<0.05)。结论预防性使用硫培非格司亭能够较好地减少肿瘤化疗引起的中性粒细胞减少症(尤其是发热性中性粒细胞减少症)的发生,在临床治疗上的有效性和安全性优于rhG-CSF。

Objective To investigate the effectiveness and safety of mecapegfilgrastim for the clinical treatment of chemotherapy-induced neutropenia in cancer patients.Methods A retrospective analysis was used to study totally 288 patients with malignant tumors who preventively used mecapegfilgrastim and recombinant human granulocyte stimulating factor(rhG-CSF)after chemotherapy in Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences from January 2019 to January 2021.According to the different selection of whitening drugs,the enrolled patients were divided into mecapegfilgrastim group(experimental group,184 cases)and rhG-CSF group(control group,104 cases).The information of patients was collected and recorded,and the results were analyzed.Results The number of days that the absolute neutrophil count(ANC)and white blood cell count(WBC)decreased below the normal range after chemotherapy and the number of days that the ANC and WBC returned to the normal range after chemotherapy in the experiment group were less than those in the control group(P<0.05),the maintenance days of ANC and WBC in the experiment group were more than those in the control group after they returned to the normal range(P<0.05).There was no significant difference in the incidence of bone marrow suppression between the experiment group and the control group(P>0.05),however,the incidence of fever neutropenia in the control group was higher than that in the experiment group(P<0.05).The total incidence of adverse reactions in the experiment group was lower than that in the control group(P>0.05).Conclusion The preventive use of mecapegfilgrastim could better reduce the incidence of neutropenia(especially fever neutropenia)caused by tumor chemotherapy,and it is more effective and safer in clinical treatment than rhG-CSF.