不同补铁方法联合ESAs治疗肿瘤相关性贫血  

Different iron supplementation methods combined with ESAs for treatment of cancer related anemia

作　　者：张洽 王春光[1] 刘永立[1] ZHANG Qia;WANG Chun-guang;LIU Yong-li(Department of Oncology, Yongchuan Hospital Affiliated to Chongqing Medical University, Chongqing 402160, China)

机构地区：[1]重庆医科大学附属永川医院肿瘤科

出　　处：《中国实用医药》2019年第15期11-13,共3页China Practical Medicine

摘　　要：目的探讨不同补铁方法联合促红细胞生成素类药物(ESAs)治疗肿瘤相关性贫血(CRA的有效性。方法 185例恶性肿瘤患者中CRA患者78例,按照补铁方法不同将患者分为A组、B组、C组,每组26例。三组患者均给予ESAs药物重组促红细胞生成素(rhEPO), A组患者给予琥珀酸亚铁,B组患者给予蔗糖铁注射液(0.1 g, 1次/周), C组患者给予蔗糖铁注射液(0.1 g, 2次/周)。分析患者不同肿瘤部位CRA发生情况,比较三组患者治疗前后血红蛋白(Hb)水平、卡氏功能状态评分(KPS评分)及治疗后临床疗效。结果 185例恶性肿瘤患者的CRA发生率为42.2%(78/185),肿瘤部位:消化道肿瘤81例, CRA患者50例;呼吸道肿瘤81例, CRA患者21例;乳腺肿瘤14例, CRA患者3例;妇科肿瘤9例, CRA患者4例;其中以消化道患者CRA发生率最高,为61.7%。三组患者治疗后4、8周的Hb水平均高于本组治疗前,差异均具有统计学意义(P<0.05)。治疗后8周, C组和B组患者的Hb水平均高于A组, C组患者的Hb水平高于B组,差异均具有统计学意义(P<0.05)。三组患者治疗后8周的KPS评分均显著高于本组治疗前,差异均具有统计学意义(P<0.05)。治疗后8周, C组和B组患者的KPS评分均高于A组, C组患者的KPS评分高于B组,差异均具有统计学意义(P<0.05)。治疗后2周,三组患者的总有效率比较,差异无统计学意义(P>0.05)。治疗后4周, C组患者的总有效率57.7%高于A组的19.2%,差异具有统计学意义(P<0.05)。治疗后8周, C组及B组患者的总有效率均高于A组, C组患者的总有效率高于B组,差异均具有统计学意义(P<0.05)。结论 CRA的患病率较高,予以铁剂联合rhEPO治疗有较好的效果,其中2次/周静脉补铁联合rhEPO效果最好。Objective To discuss the effectiveness of different iron supplementation methods combined with erythropoietin drugs(ESAs) for treatment of cancer related anemia(CRA). Methods Among 185 patients with malignant tumors, 78 patients with CRA were divided into group A, group B and group C according to different methods of iron supplementation, with 26 cases in each group. Three groups received ESAs drug recombinant erythropoietin(rhEPO), group A was also treated with ferrous succinate, group B was treated with iron sucrose injection(0.1 g, 1 time/week), and group C was treated with iron sucrose injection(0.1 g, 2 times/week).The incidence of CRA in different tumor sites was analyzed, and the levels of hemoglobin(Hb), Karnofsky functional status score(KPS score) before and after treatment and clinical efficacy after treatment were compared between the three groups. Results The incidence of CRA in 185 inpatients with malignant tumors was 42.2%(78/185). Tumor site: 81 cases of digestive tract tumors, with 50 cases of CRA;81 cases of respiratory tumors,with 21 cases of CRA;14 cases of breast tumors, with 3 cases of CRA;9 cases of gynecological tumors, with4 cases of CRA. Among them, the incidence of CRA in patients with digestive tract was the highest as 61.7%.Three groups had higher Hb levels after 4 and 8 weeks of treatment than those before treatment, and the differences were statistically significant(P<0.05). After 8 weeks of treatment, group C and group B had higher Hb than group A, and group C had higher Hb than group B. Their difference was statistically significant(P<0.05). Three groups had significantly higher KPS score after 8 weeks of treatment than those before treatment, and the difference was statistically significant(P<0.05). After 8 weeks of treatment, group C and group B had higher KPS score than group A, and group C had higher KPS score than group B. Their difference was statistically significant(P<0.05).After 2 weeks of treatment, three groups had no statistically significant difference in total effecti

关 键 词：肿瘤相关性贫血 恶性肿瘤 铁剂 促红细胞生成素类药物 重组促红细胞生成素 

分 类 号：R730.5[医药卫生—肿瘤] R556[医药卫生—临床医学]