rhG-CSF不同给药途径对化疗后中性粒细胞减少症的疗效  

Effects of different administration routes of recombinant human granulocyte colony-stimulating factor on neutropenia induced by chemotherapy

作　　者：李腾 张佳思 魏玲 赵永利 孙溦 徐双年 王丽华 LI Teng;ZHANG Jiasi;WEI Ling;ZHAO Yongli;SUN Wei;XU Shuangnian;WANG Lihua(Admin Office,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Center for Hematology,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Teaching-research Office of Nursing,The First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院院办,重庆400038 [2]陆军军医大学第一附属医院血液科,重庆400038 [3]陆军军医大学第一附属医院护理教研室,重庆400038

出　　处：《重庆医学》2022年第4期658-662,共5页Chongqing medicine

摘　　要：目的比较重组人粒细胞集落刺激因子(rhG-CSF)皮下注射(SC)与静脉注射(IV)治疗非霍奇金淋巴瘤(NHL)化疗后中性粒细胞减少症(CIN)的效果。方法收集该院血液科2015年1月至2020年8月接受rhG-CSF治疗CIN的NHL患者资料。采用倾向性评分(PS)匹配和PS回归调整以控制混杂偏倚。主要结局指标包括:患者中性粒细胞绝对值(ANC)恢复至≥0.1×10^(9)/L和≥0.5×10^(9)/L所需时间、CIN恢复速率;次要结局指标包括:感染发生率及中性粒细胞减少性发热(FN)持续时间。结果308例患者(SC组108例,IV组200例)符合纳入排除标准。多种PS方法处理后的统计结果一致表明,与IV组相比,SC组ANC恢复至≥0.1×10^(9)/L和≥0.5×10^(9)/L所需时间更短(P<0.05),CIN恢复速率更快(P<0.05),感染发生率更低(P<0.05);两组间FN持续时间无明显差异(P>0.05)。结论SC rhG-CSF治疗NHL患者CIN的效果明显优于IV rhG-CSF。Objective To compare the effects of subcutaneous(SC)and intravenous(IV)recombinant human granulocyte colony-stimulating factor(rhG-CSF)on chemotherapy-induced neutropenia(CIN)in patients with non-Hodgkin′s lymphoma(NHL).Methods Data of patients with NHL receiving rhG-CSF for CIN in the hematology department of this hospital from January 2015 to August 2020 were collected.Propensity score(PS)matching and PS regression adjustment were used to control the confounding bias.The main outcomes were the time to absolute neutrophil count(ANC)recovery of≥0.1×10^(9)/L and≥0.5×10^(9)/L,and CIN recovery rate.Secondary outcomes were the duration of febrile neutropenia(FN)and the incidence of infections.Results A total of 308 patients(108 cases in group SC and 200 cases in group IV)who met inclusion and exclusion criteria were included.Multiple PS analytic approaches achieved consistent results:compared with group IV,the time to ANC recovery of≥0.1×10^(9)/L as well as of≥0.5×10^(9) was shorter,CIN recovery rate was faster and the infection rate was lower in group SC(P<0.05).There was no significant difference in FN duration between the two groups(P>0.05).Conclusion SC rhG-CSF is much more potent than IV injection in ameliorating CIN in patients with NHL.

关 键 词：中性粒细胞减少 粒细胞集落刺激因子 化学治疗 投药途径 倾向性评分 

分 类 号：R733[医药卫生—肿瘤] R452[医药卫生—临床医学]