长、短效重组人粒细胞刺激因子对恶性肿瘤患者白细胞减少症的有效性及经济性分析  

Efficacy and Cost-effectiveness Analysis of Long or Short Recombinant Human Granulocyte Stimulating Factor on Malignant Tumor Patients with Leucopenia

作　　者：张伟[1] 王研[2] 丁年羊[2] 刘小林[2] 王超[1] 翟建皓 吴君[3] ZHANG Wei;WANG Yan;DING Nianyang;LIU Xiaolin;WANG Chao;ZHAI Jianhao;WU Jun(Pharmacy Department,Nanjing University of Traditional Chinese Medicine Affiliated Nanjing Hospital of Traditional Chinese and Western Medicine,Nanjing,Jiangsu,210000,China;Pharmacy Department,Jiangsu Cancer Hospital,Nanjing,Jiangsu,210009,China;Cardiology Department,Wuxi People’s Hospital,Wuxi,Jiangsu,214023,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院药剂科,江苏南京210000 [2]江苏省肿瘤医院药剂科,江苏南京210009 [3]无锡市人民医院心内科,江苏无锡214023

出　　处：《肿瘤药学》2018年第5期811-814,共4页Anti-Tumor Pharmacy

基　　金：国家自然科学青年基金(81503076)

摘　　要：目的探讨长、短效重组人粒细胞刺激因子对恶性肿瘤患者化疗后白细胞减少症的治疗有效性及经济性。方法选取59例经病理诊断确诊为Ⅲ期肺癌并行化疗后出现IV度骨髓抑制(WBC<1×10~9 L^(-1))的患者为研究对象,按照随机数字表法分为实验组(29例)和对照组(30例)。实验组给予聚乙二醇化重组人粒细胞刺激因子皮下注射,对照组给予重组人粒细胞刺激因子皮下或静脉注射。观察两组患者治疗前及治疗第3 d的WBC水平,比较两组患者从开始治疗至WBC恢复至正常水平(WBC>4×10~9 L^(-1))的时间,比较两组患者治疗期间的不良反应发生率,分析并比较两组治疗方案的经济性。结果治疗前及治疗第3 d,两组患者WBC水平比较,差异均无统计学意义(P>0.05);实验组患者WBC恢复正常的时间短于对照组,差异有统计学意义(P<0.05),两组治疗过程中均无患者死亡;实验组治疗期间的不良反应发生率低于对照组,差异有统计学意义(P<0.05);实验组治疗费用高于对照组,差异有统计学意义(P<0.05)。结论长效重组人粒细胞刺激因子具有更高的安全性及更短的治疗周期,但费用较为昂贵。Objective To investigate the efficacy and economy of long-short-acting recombinant human granulocyte stimulating factor in treatment of malignant tumor patients with leucopenia after chemotherapy. Methods Fifty-nine patients who was pathologically diagnosed of stage Ⅲ lung cancer in our hospital and got grade IV myelosuppression(WBC<1×109 L-1) after chemotherapy, were selected as study subjects. According to random numbers, they were divided into experiment group(n=29) and control group(n=30). The patients in the experiment group were treated with pegylated recombinant human granulocyte stimulating factor subcutaneously. Those in control group received recombinant human granulocyte stimulating factor subcutaneously or intravenously. The WBC counts before treatment and at the third day of treatment were observed in both groups. The time required for the two groups to start their treatment until the WBC returned to normal level(WBC> 4×109 L-1) was recorded and compared. The incidence of adverse reactions was also compared between the two groups. Finally, the cost-effectiveness of the two groups was analyzed and compared. Results There was no significant difference in WBC levels between the two groups before treatment and at the third day of treatment(P>0.05). Patients in the experiment group spent less time that those in control group to have their WBC levels returned to normal(P<0.05). There was no death in both groups during the course of treatment. The incidence of adverse reactions in the experiment group was lower than in the control group, and the difference was statistically significant(P<0.05). The experiment group cost more than the control group(P<0.05). Conclusion Long-acting recombinant human granulocyte stimulating factor has higher safety and shorter treatment cycle, but it is more expensive.

关 键 词：重组人粒细胞刺激因子 白细胞减少症 有效性 

分 类 号：R730.6[医药卫生—肿瘤]