重组人粒细胞集落刺激因子在儿童急性髓细胞白血病诱导治疗中的疗效及卫生经济学评价  

Evaluation of efficacy and medical economics for recombinant human granulocyte colony-stimulating factor in therapy of induction for acute myeloid leukemia in childhood

作　　者：喻金凤 林光燕 肖剑文[1,2,3] 高勇[1,2,5] YU Jinfeng;LIN Guangyan;XIAO Jianwen;GAO Yong(Blood Tumor Center,Children′s Hospital Affiliated to Chongqing Medical University,Chongqing 400014,China;Key Laboratory of Child Development Disease Research of Ministry of Education,Chongqing 400014,China;Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China;Department of Finance,Children′s Hospital Affiliated to Chongqing Medical University,Chongqing 400014,China;Department of Nursing Care,Children′s Hospital Affiliated to Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院血液肿瘤中心,重庆400014 [2]儿童发育疾病研究教育部重点实验室,重庆400014 [3]儿科学重庆市重点实验室,重庆400014 [4]重庆医科大学附属儿童医院护理部,重庆400014 [5]重庆医科大学附属儿童医院财务处,重庆400014

出　　处：《现代医药卫生》2019年第6期807-810,共4页Journal of Modern Medicine & Health

基　　金：重庆市科学技术委员会社会事业与民生保障科技创新专项项目(cstc2016shms-ztzx0042)

摘　　要：目的评价人重组粒细胞集落刺激因子(rhG-CSF)在儿童急性髓细胞白血病(AML)诱导缓解治疗中的疗效及其卫生经济学价值。方法选取2007年1月至2015年12月重庆医科大学附属儿童医院收治并接受治疗的初诊AML患儿181例,根据是否应用rhG-CSF分为治疗组(69例)和对照组(112例),比较2组治疗情况及治疗费用等。结果 2组患儿化疗后中性粒细胞绝对值(ANC)最低值比较,差异无统计学意义(P>0.05)。治疗组粒细胞减少期短于对照组,差异有统计学意义(P<0.05);治疗组粒细胞缺乏期短于对照组,但差异无统计学意义(P>0.05)。2组完全缓解(CR)率分别为84.82%和79.71%,差异无统计学意义(P>0.05)。2组化疗后肺炎及胃肠道感染发生情况比较,差异无统计学意义(P>0.05),而对照组败血症发生率高于治疗组,粒细胞缺乏伴发热时间短于治疗组,差异均有统计学意义(P<0.05)。治疗组平均住院时间长于对照组,差异有统计学意义(P<0.05);2组住院总费用和药品支出费用比较,差异无统计学意义(P>0.05)。结论 rhG-CSF能显著缩短AML患儿诱导缓解化疗后中性粒细胞减少的时间,但不能缩短发生严重感染的关键期,也不可降低严重感染风险或提高AML患儿CR率,且应用rhG-CSF治疗时的相关卫生经济学指标无明显改善。Objective To evaluate the efficacy of recombinant human granulocyte colony-stimulating factor(rhG-CSF) in the induction and remission of childhood acute myeloid leukemia(AML) and its hygienic and economic value. Methods 181 newly diagnosed AML children admitted to the Children′s Hospital Affiliated to Chongqing Medical University from January 2007 to December 2015 were selected and divided into treatment group(69 cases) and control group(112 cases) according to whether rhG-CSF was applied.The treatment status and treatment cost of the two groups were compared. Results There was no significant difference in ANC between the two groups after chemotherapy( P >0.05).The reduction period of granulocytes in the study group was shorter than that in the control group,and the difference was statistically significant( P <0.05).The period of granulocyte deficiency in the treatment group was shorter than that in the control group,but there was no significant difference( P >0.05).The CR rates of the two groups were 84.82% and 79.71% respectively,and there was no significant difference( P >0.05).There was no significant difference in the incidence of pneumonia and gastrointestinal tract infection between the two groups after chemotherapy( P >0.05),but the incidence of sepsis in the control group was higher than that in the treament group,and the time of fever associated with granulocyte deficiency in the control group were shorter than those in the treatment group( P <0.05).The average hospitalization days in the treatment group were higher than those in the control group( P <0.05),and there was no significant difference in total hospitalization expenses and drug expenditure between the two groups( P > 0.05). Conclusion RhG-CSF can significantly shorten the time of induction and remission of neutropenia in children with AML after chemotherapy,but it can not shorten the critical period of severe infection,reduce the risk of severe infection or increase the CR rate in children with AML.Moreover,there is no significant improveme

关 键 词：粒细胞集落刺激因子 重组 白血病 髓样 急性 卫生经济学 

分 类 号：R733.7[医药卫生—肿瘤]