联用rhIL-11和rhG-CSF的血液恶性肿瘤患者粒细胞缺乏时间及其影响因素分析  

Analysis of Agranulocytosis Time and Its Influencing Factors in Patients with Hematological Malignancies Treated with rhIL-11 combined rhG-CSF

作　　者：魏寒梅 李子坚[2] 王丽娜[2] WEI Han-Mei;LI Zi-Jian;WANG Li-Na(The First School of Clinical Medicine,The First Hospital of Lanzhou University,Lanzhou 730000,Gansu Province,China;Department of Hematology,The First Hospital of Lanzhou University,Lanzhou 730000,Gansu Province,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院血液内科,甘肃兰州730000

出　　处：《中国实验血液学杂志》2022年第3期930-936,共7页Journal of Experimental Hematology

摘　　要：目的:探讨重组人白介素-11(rhIL-11)联合重组人粒细胞集落刺激因子(rhG-CSF)治疗化疗后血液肿瘤患者粒缺持续时间和严重程度的干预作用,以及对其影响因素进行分析。方法:回顾性收集兰州大学第一医院血液科2017年7月-2020年7月收治的在化疗后联合应用rhIL-11和rhG-CSF血液肿瘤患者资料,通过单因素分析比较不同分组情况下粒缺持续时间情况及差异,多元回归分析进一步明确粒缺持续时间的影响因素。结果:97例患者粒缺持续时间为6.47±2.93 d。单因素分析结果显示,不同性别、年龄、身高、体重、体表面积、体质量指数(BMI)、rhG-CSF剂量、rhIL-11剂量,给予rhG-CSF和rhIL-11后是否自发性出血,给予rhG-CSF和rhIL-11前不同红细胞计数(RBC)、血红蛋白(HGB)水平、血小板数(PLT)、中性粒细胞数绝对值(ANC)的患者粒缺持续时间比较,差异均无统计学意义(P>0.05);不同疾病类型、化疗周期、给予rhG-CSF和rhIL-11后不同发热情况、给予rhG-CSF和rhIL-11前不同白细胞数(WBC)基线的患者粒细胞缺乏时间比较,差异有统计学意义(P<0.05)。诊断为急性髓系白血病(AML)的患者与急性淋巴细胞白血病(ALL)、非霍奇金淋巴瘤(NHL)的患者相比,粒缺持续时间最长,为7.07±3.05 d。与化疗周期为4-6和≥7的患者相比,总化疗周期为1-3的患者粒缺持续时间最短,为5.25±2.48 d。在联用二种细胞因子6 d后出现发热患者,与无发热、联用细胞因子后1 d内出现发热、联用细胞因子2-5 d内出现发热患者相比,粒缺持续时间最长,为8.85±2.85 d。在联合给予细胞因子前WBC基线为≥4.0×10^(9)/L的患者,与WBC基线在<1.0×10^(9)/L、(1.0-1.9)×10^(9)/L、(2.0-3.9)×10^(9)/L的患者相比,粒缺持续时间最短,为4.50±2.56 d。多元线性回归分析显示,化疗周期、给予rhG-CSF和rhIL-11后不同发热情况、诊断为ALL和NHL、给予rhG-CSF和rhIL-11前WBC基线水平是粒缺持续时间的影响因�Objective:To explore the intervention effect of recombinant human interleukin-11(rhIL-11)and recombinant human granulocyte-colony stimulating factor(rhG-CSF)on the duration and severity of agranulocytosis in patients with hematological malignancies after chemotherapy,and to analyze the influencing factors.Methods:The data of hematological malignancy patients treated with rhIL-11 and rhG-CSF after chemotherapy in the hematology department of The First Hospital of Lanzhou University from July 2017 to July 2020 were collected retrospectively.The duration and differences of agranulocytosis in differeent groups were compared by univariate analysis,and the influencing factors of agranulocytosis duration were further analyzed by multiple regression analysis.Results:The duration of agranulocytosis in 97 patients was 6.47±2.93 days.The results of univariate analysis showed that there were no statistical differences in the duration of agranulocytosis among patients with different sex,age,height,weight,body surface area,body mass index(BMI),dose of rhG-CSF,dose of rhIL-11,spontaneous bleeding after administration of rhG-CSF and rhIL-11,and the duration of agranulocytosis in patients with different red blood cell count(RBC),hemoglobin(HGB)level,platelet count(PLT)and absolute neutrophil count(ANC),before administration of rhG-CSF and rhIL-11.There were significant differences in agranulocytosis time among patients with different disease types,chemotherapy cycle,fever after rhG-CSF and rhIL-11 administration,and different white blood cell count(WBC)baseline level before rhG-CSF and rhIL-11 administration(P<0.05).Compared with patients with acute lymphoblastic leukemia(ALL)and non-Hodgkin lymphoma(NHL),patients with acute myeloid leukemia(AML)had the longest duration of agranulocytosis,which was 7.07±3.05 d.Compared with patients with chemotherapy cycles of 4-6 and≥7,patients with total chemotherapy cycle of 1-3 had the shortest duration of agranulocytosis,which was 5.25±2.48 d.Compared with patients without fever,patient

关 键 词：重组人白介素-11 重组人粒细胞集落刺激因子 血液恶性肿瘤 粒细胞缺乏时间 影响因素 

分 类 号：R733[医药卫生—肿瘤]