儿童神经母细胞瘤化疗后严重感染的影响因素及重组人粒细胞刺激因子的预防效果  

Study on the Influencing Factors of Severe Infection in Children with Neuroblastoma after Chemotherapy and the Preventive Effect of Recombinant Human Gra-nulocyte Colony-stimulating Factor

作　　者：王亮[1] 薛海蓉[1] 曹献云[1] WANG Liang;XUE Hairong;CAO Xianyun(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2021年第2期341-344,共4页The Practical Journal of Cancer

摘　　要：目的探讨儿童神经母细胞瘤化疗后严重感染的影响因素及重组人粒细胞刺激因子(rhG-CSF)的预防效果。方法回顾性分析儿童神经母细胞瘤114例临床资料,包括患儿性别、年龄、临床分期、原发部位、远处转移、血清神经元特异性烯醇化酶(NSE)水平、手术切除、化疗药物、化疗维持时间,统计所有患儿化疗后严重感染发生率并分析判断以上各项是否为影响因素。将114例儿童分为2组,其中在停化疗24 h后立即予以rhG-CSF进行预防干预的64例患儿作为观察组,出现粒细胞缺乏后再给予rhG-CSF干预的50例患儿作为对照组,比较2组严重感染的预防效果。结果114例的儿童神经母细胞瘤严重感染发生率为27.2%(31/114),其中年龄≤18月、临床分期Ⅲ~Ⅳ期、有远处转移、血清NSE>100 ng/ml、手术切除、化疗药物环磷酰胺+阿霉素+长春新碱、化疗维持时间≥6个月的患儿严重感染发生率更高(P<0.05)。多因素logistic回归分析显示年龄、临床分期、血清NSE水平、化疗药物、化疗维持时间是儿童神经母细胞瘤化疗后感染的影响因素。观察组的严重感染发生率显著低于对照组,并且感染持续时间显著短于对照组,差异均有统计学意义(P<0.05)。结论儿童神经母细胞瘤化疗后感染受到年龄、临床分期、血清NSE水平、化疗药物、化疗维持时间等多种因素影响,在停化疗24 h后立即予以rhG-CSF进行预防干预,能够显著降低严重感染发生率,改善患儿预后。Objective To investigate the influencing factors of severe infection in children with neuroblastoma after chemotherapy and the preventive effect of recombinant human gra-nulocyte colony-stimulating factor.Methods The clinical data of 114 cases of childhood neuroblastoma treated with chemotherapy were retrospectively analyzed,including the child's gender,age,clinical stage,primary site,distant metastasis,serum neuron-specific enolase(NSE)level,surgical resection,chemotherapy drugs,chemotherapy maintenance time,the incidence of serious infections in all children after chemotherapy was counted and the above items whether or not influencing factors were analyzed.Among them,64 cases of children who were treated with rhG-CSF for preventive intervention immediately after chemotherapy was stopped for 24 hours as the observation group,and 50 children who were treated with rhG-CSF after the occurrence of agranulocytosis as the control group,the preventive effects of severe infections of the 2 groups were compared.Results The serious infection rate of 114 cases of childhood neuroblastoma was 27.2%(31/114),The serious infection rate of childhood with age≤18 months,clinical stageⅢtoⅣ,distant metastasis,serum NSE>100 ng/ml,surgical resection,cyclophosphamide+adriamycin+vincristine and chemotherapy maintenance time≥6 months was higher(P<0.05),multivariate logistic regression analysis showed that age,clinical stage,serum NSE level,chemotherapeutic drugs,and chemotherapy maintenance time were the influencing factors of childhood neuroblastoma infection after chemotherapy.The incidence of severe infection in the observation group was significantly lower than that in the control group,and the duration of infection was significantly shorter than that of the control group,the differences were statistically significant(P<0.05).Conclusion The serious infection of children with neuroblastoma after chemotherapy is affected by many factors such as age,clinical stage,serum NSE level,chemotherapeutic drugs and chemotherapy maintenan

关 键 词：神经母细胞瘤 儿童 神经发育 化疗 重组人粒细胞刺激因子 影响因素 预防效果 

分 类 号：R739.41[医药卫生—肿瘤]