摘要
目的 探讨聚乙二醇化重组人粒细胞刺激因子(PEG-rhG-CSF)预防急性淋巴细胞白血病(ALL)患儿化疗后中性粒细胞减少的临床疗效.方法 回顾性分析2020年7月至2023年7月在绵阳市中心医院就诊的60例急性ALL患儿的临床资料.根据治疗方法不同将患儿分为观察组和对照组,各30例.对照组采用重组人粒细胞刺激因子(rhG-CSF)进行干预,观察组采用PEG-rhG-CSF进行干预.比较两组患儿化疗前及化疗3周后绝对中性粒细胞计数(ANC)和白细胞计数(WBC)水平,化疗后3周的中性粒细胞减少的开始时间、持续时间和结束时间,比较两组患儿化疗3周后在白细胞降低发生率、中性粒细胞减少症(FN)发生率及不良反应发生率.结果 化疗3周后,两组患者的ANC、WBC水平均较化疗前升高,且观察组患儿的ANC、WBC水平分别为(6.77±4.22)×109/L、(9.17±3.36)× 109/L,均明显高于对照组[(6.34±2.34)×109/L、(8.91±3.56)× 109/L],差异均有统计学意义(P＜0.05).两组患儿中性粒细胞减少的开始时间比较,差异无统计学意义(P＞0.05);观察组患儿中性粒细胞减少的持续时间和结束时间分别为(8.99±3.31)、(4.79±1.18)d,均明显短于对照组[(15.56±4.91)、(6.97±3.32)d],差异均有统计学意义(P＜0.05).观察组患儿白细胞降低率、FN实际发生率、再住院率和抗生素使用率分别为30.00％、10.00％、3.33％、3.33％,均明显低于对照组(56.67％、40.00％、43.33％、36.67％),差异均有统计学意义(P＜0.05).观察组患儿的ANC减少、感染、骨骼肌肉酸痛、腹泻、恶心呕吐发生率分别为16.67％、6.67％、3.33％、6.67％、10.00％,均明显低于对照组(43.33％、30.00％、16.67％、26.67％、36.67％),差异均有统计学意义(P＜0.05).结论 PEG-rhG-CSF 能明显缩短急性ALL患儿化疗后中性粒细胞减少的持续时间和结束时间,且不良反应发生率低,在预防急性ALL患儿化疗后中性粒细胞减少方面疗效显著,安全性较高.
Abstract
Objective To investigate the clinical efficacy of pegylated recombinant human granulocyte stimulating factor(PEG-rhG-CSF)in preventing neutropenia in children with acute lymphoblastic leukemia(ALL)after chemotherapy.Methods The clinical data of 60 chil-dren with ALL treated in Mianyang Central Hospital from July 2020 to July 2023 were retrospectively analyzed.According to different treatment methods,the children were divided into the observation group and the control group,30 cases of each group.The control group were treated with recombinant human granulocyte stimulating factor(rhG-CSF),and the observation group were treated with PEG-rhG-CSF.The absolute neu-trophil count(ANC)and white blood cell count(WBC)levels before chemotherapy and after 3 weeks of chemotherapy,the start time,duration,and end time of neutropenia at 3 weeks after chemotherapy,the efficacy in reducing the incidence of leukocytosis and febrile neutropenia(FN)and the incidence of adverse reactions were compared between the two groups.Results After 3 weeks of chemotherapy,the levels of ANC and WBC in two groups of patients were higher than those before chemotherapy,and the levels of ANC and WBC in the observation group of patients were(6.77±4.22)×109/L,(9.17±3.36)×109/L,respectively,which were significantly higher than those in the control group[(6.34±2.34)]× 109/L,(8.91±3.56)×109/L,and the difference were statistically significant(P＜0.05).There was no statistically significant difference in the start time of neutropenia between the two groups of children(P＞0.05);the duration and end time of neutropenia in the observation group were(8.99±3.31)and(4.79±1.18)d,respectively,which were significantly shorter than those in the control group[(15.56±4.91)and(6.97±3.32)d],and the difference were statistically significant(P＜0.05).The rate of leukopenia,the actual incidence of FN,the rate of re-hospitalization and the use rate of antibiotics in observation group were 30.00％,10.00％,3.33％,3.33％,respectively,which were significantly lower than those in control group(56.67％,40.00％,43.33％,36.67％),and the difference were statistically significant(P＜0.05).The incidence rates of ANC reduction,infection,skeletal muscle soreness,diarrhea,and nausea and vomiting in the observation group were 16.67％,6.67％,3.33％,6.67％,and 10.00％,respectively,which were significantly lower than those in the control group(43.33％,30.00％,16.67％,26.67％,36.67％),and the difference were statistically significant(P＜0.05).Conclusion PEG-rhG-CSF can significantly shorten the duration and recovery time of neutropenia after chemotherapy in children with ALL,and the incidence of adverse reactions were low.It were effective and safe in preventing neutropenia after chemotherapy in children with ALL.
基金项目
四川省基层卫生事业发展研究中心项目(SWFZ16-Y-29)
维普
万方数据