粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合动员异基因造血干细胞移植

背景：目前FDA已批准应用于临床外周血造血干细胞移植的动员剂只有粒细胞集落刺激因子和粒-巨噬细胞集落刺激因子,其中粒细胞集落刺激因子单药应用是目前最主要的动员方案,但可引起供者骨骼肌肉酸痛、发热等不良反应。目的：回顾性分析以粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合应用为动员方案的异基因造血干细胞移植临床效果。方法：选择2004-01/2009-10河南省人民医院血液科以粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子联合应用为动员方案进行血缘全相合异基因造血干细胞移植51例,分析移植物成分、造血重建及移植物抗宿主病的发生率。结果与结论：动员96h后CD34＋细胞占单个核细胞的比例为（0.97±0.13）%,CD34＋CD38-细胞占CD34＋细胞的比例为（37.49±4.03）%;移植后的快速造血重建与CD34＋细胞、CD34＋CD38-细胞输入量呈负相关。Ⅰ度、Ⅱ～Ⅳ度急性移植物抗宿主病的发生率分别为25.5%,15.7%;局限性、广泛性慢性移植物抗宿主病的发生率分别为39.2%,21.2%。提示在血缘全相合异基因造血干细胞移植中,粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子联合可有效实现干细胞动员,所获CD34＋细胞完全可以满足快速造血重建的需要;输入较多的CD34＋细胞、CD34＋CD38-细胞可能利于快速造血重建。     

CD4+CD25+FOXP3+Treg细胞与急性移植物抗宿主病的关系

背景：CD4+CD25+FOXP3+Treg细胞具有免疫抑制作用,推测可能减少异基因造血干细胞后急性移植物抗宿主病的发生率。目的：观察粒细胞集落刺激因子动员前后,供者外周血CD4+CD25+FOXP3+Treg细胞比率变化,并探讨CD4+CD25+FOXP3+Treg细胞与异基因造血干细胞移植后发生急性移植物抗宿主病的关系。方法：以异基因造血干细胞移植受者90例及其供者为研究对象,供者皮下注射重组人粒细胞集落刺激因子(5μg/kg),1次/12 h,连续5 d后,采集干细胞;分别于动员前后采集供者外周血,流式细胞仪检测其中CD4+CD25+FOXP3+Treg细胞含量,及受者接受移植物中此类细胞含量;根据接受CD4+CD25+FOXP3+Treg细胞数分为高剂量组(细胞比例≥5%)及低剂量组(细胞比例<5%),比较两组移植后急性移植物抗宿主病的发生率。结果与结论：供者在应用粒系集落刺激因子动员前后CD4+CD25+FOXP3+Treg细胞比例分别为11.3%和1.5%,差异有显著性意义(P<0.05);急性移植物抗宿主病阳性组所接受移植物中该群细胞比例为3.4%,阴性组为15.7%,差异有显著性意义(P <0.05);移植造血重建后高剂量组急性移植物抗宿主病的发生率为18.4%,低剂量组急性移植物抗宿主病的发生率为48.1%,二者差异有显著性意义(P<0.05)。因而,粒系集落刺激因子应用能降低正常人外周血中CD4+CD25+FOXP3+Treg细胞比例;CD4+CD25+FOXP3+Treg细胞增加可以降低急性移植物抗宿主病的发生率。     

膀胱内灌注粒细胞-巨噬细胞集落刺激因子预防造血干细胞移植后出血性膀胱炎发生

背景:出血性膀胱炎是造血干细胞移植后常见并发症之一.粒细胞一巨噬细胞集落刺激因子除影响造血干/祖细胞的增殖和分化外,还能调节炎性反应中单核细胞、粒细胞、淋巴细胞以及内皮细胞的功能.目的:探讨膀胱内灌注粒细胞一巨噬细胞集落刺激因子对造血干细胞移植后出血性膀胱炎的预防作用.设计:病例分析.对象:中山大学附属中山医院2004-01/2006-08接受异基因造血干细胞移植的血液病患者15例作为常规治疗组,2006-09/2008-12接受异基因造血干细胞移植的血液病患者16例作为粒细胞-巨噬细胞集落刺激因子组.方法:常规治疗组采用常规方法即美司钠、水化、碱化尿液预防出血性膀胱炎,粒细胞-巨噬细胞集落刺激因子组在其基础上,在应用环磷酰胺前24 h开始向膀胱内灌注粒细胞-巨噬细胞集落刺激因子,至环磷酰胺停用3 d后拔除导尿管,用生理盐水冲洗膀胱后排空膀胱,然后向300 μg粒细胞-巨噬细胞集落刺激因子中加入生理盐水10 mL、利多卡因5 mL注入膀胱,保留60～120 min.主要观察指标:出血性膀胱炎的发生及其与移植物抗宿主病的相关性,巨细胞病毒感染及泌尿系统感染的发生情况.结果:与常规治疗组比较,粒细胞-巨噬细胞集落刺激因子组出血性膀胱炎发生率明显降低(x<'2>=4.39,P<0.05),出血性膀胱炎平均持续时间、患者平均住院时间均明显缩短(t=3.97,P<0.05;t=3.13,P<0.05),Ⅲ度以上出血性膀胱炎发生率明显降低(x2=5.04,P<0.05).出血性膀胱炎严重程度与移植物抗宿主病严重程度、持续时间有关(r=0.76).与常规治疗组比较,粒细胞-巨噬细胞集落刺激因子组巨细胞病毒感染率略微下降但无明显差异(x<'2>=0.28,P>0.05),巨细胞病毒感染阳性患者Ⅲ度以上出血性膀胱炎发生率升高.与常规治疗组比较,粒细胞-巨噬细胞集落刺激因子组泌尿系统感染发生率略微下降但无明显差异(x2=0.28,P>0.05).结论:粒细胞-巨噬细胞集落刺激因子膀胱内灌注耐受性好,临床取得了较好疗效,是预防造血干细胞移植后出血性膀胱炎的有效措施.     

粒细胞集落刺激因子及其类似物的免疫调节作用以及在异基因造血干细胞移植中的应用

粒细胞集落刺激因子(G-CSF)不仅是一类重要的造血干细胞动员剂,还具有广泛的免疫调节作用,诱导T细胞免疫耐受,给供者应用可减轻急性移植物抗宿主病而不削弱移植物抗肿瘤效应,而受者移植后早期应用G-CSF可影响免疫重建,并有可能增加移植物抗宿主病及移植相关死亡的发生,降低移植疗效.本文就G-CSF及其类似物的免疫调节作用和在异基因造血干细胞移植中的应用作-综述.     

经粒系集落刺激因子刺激外周血CD34~+细胞动员效果相关因素的考察

目的探讨粒系集落刺激因子(G-CSF)动员健康供者外周血造血干细胞效果的影响因素。方法对24例健康供者皮下注射G-CSF动员造血干细胞,检测外周血T淋巴细胞亚群和血常规数据。结果经G-CSF刺激后,外周血CD3+(%)、CD3+CD4+(%)、白细胞计数、血小板均明显升高(P0.05);而动员第4天、第5天、第6天骨有核细胞密度、CD34+细胞百分比无明显差别。经相关性分析,性别、年龄、体质量与CD34+细胞百分比呈负相关(P0.05),白细胞计数呈正相关(P0.01)。结论在一定范围内男性供者优于女性供者,年龄越小,体质量越轻,白细胞计数越高,经G-CSF动员的外周血造血干细胞CD34+细胞百分比越高。     

粒细胞集落刺激因子与异基因造血干细胞移植中移植物抗宿主病及移植物抗白血病的免疫调节效应

文章从细胞水平、动物模型、临床应用等方面对粒细胞集落刺激因子在移植物抗宿主病和移植物抗白血病中的免疫调节作用作进一步的研究.得出结论:粒细胞集落刺激因子可从T细胞、抗原递呈细胞、调节性T细胞、自然杀伤细胞等途径发挥其免疫调节作用,诱导移植物中的T细胞产生免疫耐受,使得移植物抗宿主病和移植物抗白血病效应产生分离,从而改善异基因造血干细胞移植患者的预后,因此,输注经粒细胞集落刺激因子动员的供者淋巴细胞是其中值得关注的、有前途的一种方法.但其作用的途径机制、输注的时机、输注的细胞数等仍有待进一步的实验室和临床研究.     

国产与进口粒细胞集落刺激因子动员外周血造血干细胞的效果对照

为评估国产重组人粒细胞集落刺激因子在动员外周造血干细胞的效果,选择2001/2005收治的20例自体外周血造血干细胞移植患者,男11例,女9例,其中急性髓细胞白血病11例,急性淋巴细胞白血病5例,恶件淋巴瘤3例,多发性骨髓瘤1例.根据患者对约价承受能力分为2组:国产重组人粒细胞集落刺激因子动员组、进口重组人粒细胞集落刺激因子动员组,每组各10例,除急性髓细胞白血病采用大剂量阿糖胞昔动员外,其他均应用大剂量环磷酰胺动员,当白细胞降全低谷开始回升时加国产与进口重组人粒细胞集落刺激因子,白细胞升至5×109L-1以上开始采集外周血造血干细胞.所有患者均移植成功,两者在给药剂量、用约天数,采集干细胞质量、造血功能重建及药物毒副反应等方面差异均无显著性意义.     

CD34+细胞分选及临床应用

CD34+是造血干细胞的免疫表型。采用某种方法选择CD34+细胞,选择后CD34+细胞浓集,其百分率有较大增高,并可以有效去除T细胞及某些恶性肿瘤细胞。选择CD34+细胞移植可以减少异基因移植后急性、重度移植物抗宿主病(GVHD),并可能减少自体移植后原发病复发。本文介绍了造血干细胞的免疫表型,生物学特性及CD34+细胞分选方法、临床应用等方面的研究进展。     

粒系集落刺激因子对外周血T淋巴细胞亚群的影响及与CD34+细胞动员效果的相关性

本研究观察粒系集落刺激因子(G—CSF)作为造血干细胞动员剂对外周血T淋巴细胞亚群的影响及与CD34^ 细胞动员效果的关系。对26例行自体造血干细胞移植患在G—CSF动员前后收集外周血标本，用流式细胞术检测动员前后CD3^ 、CD3^ CD4^ 、CD3^ CD8^ 、CD3^ CD4^ CD8^ 及CD3^ CD4^-CD8细胞绝对数量的变化并与外周血CD34^ 细胞的动员效果进行相关性分析。结果表明：GCSF动员后外周血CD3^ 、CD3^ CD4^ 、CD3^ CD4^ CD8^ 及CD3^ CD4^-CD8细胞的绝对数量分别增加2.23，2．62，2.99及10．96倍，而CD3^ CD4^ CD8^ 细胞的变化无统计学意义(P=0．243)。各亚群细胞的变化与CD34^ 细胞动员效果比较，仅CD3^ CD4 CD8细胞的变化与CD34^ 细胞动员效果间具有良好的相关性，r=0．796，P=0.000。结论：G—CSF将造血干细胞由骨髓动员到外周血的同时，使外周血中T细胞亚群的绝对数量发生不同程度的变化。在各T淋巴细胞亚群中CD3^ CD8^-细胞的增加与CD34^ 细胞的动员效果间具有统计学意义的相关性。     

米托蒽醌、阿糖胞苷、粒细胞集落刺激因子的动员方案及大容量采集自体外周血干细胞

背景:外周血干细胞移植成功的首要条件是干细胞的有效动员和采集,选择高效低毒的动员方案,掌握动员和采集时机与动员效果密切相关。目的:探讨米托蒽醌-大剂量阿糖胞苷方案化疗后,单用粒细胞集落刺激因子或粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子合用对恶性血液病和实体瘤患者自体外周血干细胞的动员效果。设计:观察对比实验。单位:徐州医学院附属医院血液科。对象:选择1998-09/2006-12在徐州医学院附属医院血液科收治的42例恶性血液病和实体瘤患者,诊断符合国际白血病分型及世界卫生组织新分类标准。男25例,女17例,年龄7～54岁,平均29岁,体质量(52±18)kg。其中急性髓细胞白血病12例,急性淋巴细胞白血病6例,慢性粒细胞白血病慢性期1例,非霍奇金淋巴瘤15例,霍奇金淋巴瘤4例,多发性骨髓瘤2例,晚期乳癌2例。患者均经常规化疗达到或接近完全缓解,骨髓细胞学检查无肿瘤细胞浸润。心、肺、肝、肾等主要脏器功能正常。动员前化疗疗程平均8次,所有患者均对治疗项目知情同意。方法:患者均采用米托蒽醌10mg/(m2·d)静脉滴注第2～3d后,阿糖胞苷2g/m2静脉滴注第1～2d,1次/12h。当白细胞计数下降至最低点开始回升时,20例患者使用粒细胞集落刺激因子5～7.5μg/(kg·d),连用3～5d,22例患者早6:00给予粒细胞集落刺激因子5～7.5μg/(kg·d),晚6:00给予粒-巨噬细胞集落刺激因子5～7μg/(kg·d)。白细胞计数>2.5×109 L-1,CD34 细胞≥1%时,用CS3000plus血细胞分离机连续2d采集自体外周血干细胞,检测CD34 细胞含量和T淋巴细胞亚群。①单个核细胞与FITC标记的CD34 、CD3和CD8单抗及与CD4PE标记的CD4单抗4℃混合30min,采用流式细胞仪检测CD34 细胞和T细胞亚群,分析5×105个细胞,得出CD3、CD34 细胞含量及CD4/CD8比值。用甲基纤维素法测定粒-巨噬细胞集落形成单位。②观察术后相关不良反应。③针对不同类型疾病给予相应预处理36～48h后回输自体外周血干细胞,并行单个核细胞计数及台盼蓝染色,解冻后检测粒-巨噬细胞集落形成单位和CD34 细胞。主要观察指标:①动员前后CD34 细胞和T细胞亚群变化。②术后相关不良反应。③自体外周血干细胞回输量(单个核细胞计数、粒-巨噬细胞集落形成单位和CD34 细胞数)。结果:纳入患者42例,均进入结果分析。①动员前后CD34 细胞和T细胞亚群变化:患者应用粒细胞集落刺激因子/粒-巨噬细胞集落刺激因子动员后外周血CD34 细胞明显增加[(0.054±0.032)%,(1.82±0.76)%,P<0.01]。22例联合应用粒细胞集落刺激因子和粒-巨噬细胞集落刺激因子动员患者CD34 细胞和粒-巨噬细胞集落形成单位分别为(8.76±3.39)×106/kg,(3.52±1.33)×105/kg,明显高于单用粒细胞集落刺激因子的20例患者[(6.12±2.11)×106/kg,(2.03±1.07)×105/kg,P<0.05]。单独应用粒细胞集落刺激因子及粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子合用后随CD34 细胞增加,T淋巴细胞亚群变化不明显(P>0.05)。②外周血干细胞动员相关不良反应:全部病例出现Ⅱ～Ⅲ度脱发,血小板均有不同程度的下降,为(54.43±26.14)×109 L-1,21例患者出现感染性发热(37.8～41.0℃),经抗生素治疗感染均在短期内得到控制。13例患者在白细胞快速上升时出现骨骼疼痛(腰骶部为主)。③自体外周血干细胞回输量:自体外周血干细胞非程控冷冻-80℃保存2.0～6.5个月,细胞回收率(88.7±7.4)%,台盼蓝拒染率(92.1±5.5)%,回输的单个核细胞(5.21±2.44)×108/kg,CD34 细胞(6.89±3.55)×106/kg,粒-巨噬细胞集落形成单位(2.58±2.33)×105/kg。④循环血量每次10～16L(终点分血量均在3个TBV上)。无严重毒副反应。26例接受自体外周血干细胞移植者造血功能均获得满意重建。结论:米托蒽醌-大剂量阿糖胞苷方案化疗后单用粒细胞集落刺激因子及粒细胞集落刺激因子与粒-巨噬细胞集落刺激因子合用均能安全、有效动员自体外周血干细胞,但以合用更为有效。大容量采集是提高干细胞产率,减少采集次数的重要手段。     

化疗加G-CSF和GM-CSF联合动员自体外周血干细胞

目的　探讨化疗加粒细胞集落刺激因子 (G CSF)和粒 巨噬细胞集落刺激因子 (GM CSF)联合动员自体外周血干细胞 (APBSC)的效果。方法　卡铂 (CBP) 35 0mg m2 ,第 1天静滴 ;足叶乙甙(Vp16 ) 35 0mg m2 ,第 1～第 3天静滴 ;白细胞降至最低点又回升到 (2 .4～ 6 .4)× 10 9 L时 ,皮下注射G CSF 5 μg·kg- 1 ·d- 1 (早 6∶0 0 ) GM CSF 5 μg·kg- 1 ·d- 1 (晚 6∶0 0 ) 地塞米松 5mg d(采集日 10mg d)直到采集结束前 1天 ;白细胞上升到 (2 9.80± 5 .98)× 10 9 L ,开始用CS30 0 0plus血细胞分离机连续 2d采集APBSC。结果　 2 0例患者连续采集APBSC 2次 ,共采集到MNC(5 .93± 1.6 2 )× 10 8 kg ,CD34 细胞 (2 3.10± 11.5 3)× 10 6 kg ,CFU GM(3.44± 2 .85 )× 10 5 kg。无严重不良反应。 9例 10次自体外周血干细胞移植(APBSCT)造血功能均获满意重建。结论　以化疗联合G CSF和GM CSF能高效、安全地动员APBSC ,1次动员采集 2次可满足 1～ 2次的APBSCT。     

重型再生障碍性贫血患者血清G-CSF水平的变化

目的：观察重型再生障碍性贫血－Ⅰ型（ＳＡＡ－Ⅰ型）患者血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）水平的变化及其与病情、疗效和预后的关系。方法：采用酶联免疫法对ＳＡＡ－Ⅰ型患者治疗前血清和治疗过程中Ｇ－ＣＳＦ水平进行检测。结果：３６例ＳＡＡ－Ⅰ型患者中２７例（７５％）治疗前血清Ｇ－ＣＳＦ水平高于正常，与血清Ｇ－ＣＳＦ水平正常患者相比较，后者达到治疗有效所需疗程较短，且疗效较好；对７例患者进行动态观察显示，随着病情逐渐好转，患者血清Ｇ－ＣＳＦ水平逐渐恢复正常。结论：检测重型再生障碍性贫血患者血清Ｇ－ＣＳＦ水平有助于判断患者的病情及预测其预后。     

Granulocyte colony stimulating factor treatment for delayed recovery of ticlopidine-related neutropenia

We describe the case of a patient who developed neutropenia associated with sepsis and endophthalmitis after ticlopidine therapy for coronary stenting. The neutropenia did not resolve until granulocyte colony stimulating factor (G-CSF) was given. This uncommon case brings to attention the need for the immediate use of G-CSF in patients with delayed recovery from drug-related neutropenia and severe infection.     

Stimulation of human hematopoietic colony formation by recombinant gibbon multi-colony-stimulating factor or interleukin 3.

Recently, the gene for a novel mammalian hematopoietic growth factor homologous to murine interleukin 3 was isolated from a gibbon T cell line and expressed in monkey COS cells. The factor, termed multi-colony stimulating factor (multi-CSF) or interleukin 3, is stimulatory to human target cells. We investigated the range of enriched human bone marrow and fetal liver hematopoietic progenitors responsive to multi-CSF; compared the colony types observed with those obtained in the presence of recombinant granulocyte-macrophage CSF (GM-CSF); and analyzed the effects on colony formation of combining multi-CSF with GM-CSF or granulocyte-CSF (G-CSF). The results show that multi-CSF acts as a multipoietin. Alone it stimulates the formation of colonies derived from granulocyte, macrophage, eosinophil, and megakaryocyte progenitors. In combination with erythropoietin it supports the development of both erythroid and mixed colonies. Furthermore, the data show that multi-CSF is a more potent stimulus of erythroid progenitors than GM-CSF. In combination with G-CSF multi-CSF substantially increases granulocyte colony number over the number obtained with each factor alone. We conclude that multi-CSF may prove to have important therapeutic potential in vivo as a stimulus for hematopoiesis.     

Treatment of carbimazole-induced agranulocytosis and sepsis with granulocyte colony stimulating factor

We present the management of agranulocytosis and neutropenic sepsis secondary to carbimazole with recombinant human granulocyte colony stimulating factor (G-CSF). A 72-year-old woman with a history of thyrotoxicosis presented with sore throat and fever two weeks after starting carbimazole. Investigations confirmed a leucopenia and neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.     

Function, molecular structure and gene expression of granulocyte-macrophage colony stimulating factor]

Granulocyte-macrophage colony stimulating factor (GM-CSF), a 22 kDa glycoprotein secreted from activated T cells and stroma cells, plays an important role, both in the constructive and inducible hemopoiesis, by stimulating a wide range of hemopoietic cells. After the cloning of receptor genes, the high affinity GM-CSF receptor was reconstituted by the combination of cloned 80 kDa molecule (alpha chain) and 120 kDa molecule (beta chain). This human GM-CSF receptor beta chain also works as a beta chain of IL-3 or IL-5 high affinity receptor. The fact that the alpha chains of GM-CSF, IL-3 and IL-5 share the same beta chain may define a biological interaction among these three cytokines.     

Human recombinant granulocyte-macrophage colony stimulating factor and interleukin 3 have overlapping but distinct hematopoietic activities.

The hematopoietic stimulatory activities of human recombinant IL-3 and granulocyte-macrophage colony stimulating factor (GM-CSF) were directly compared using highly enriched human bone marrow progenitor target cells. IL-3 supported a larger number of erythroid and megakaryocytic progenitor cells than did GM-CSF, while GM-CSF supported more myeloid progenitors. IL-3 directly stimulated the division and migration of primitive erythroid burst forming units, while GM-CSF merely sustained their net survival in culture without promoting division and expansion. IL-3 promoted the formation of larger numbers of multipotential granulocyte-erythroid-macrophage-megakaryocyte colony forming unit--derived colonies than did GM-CSF. These data indicate that human IL-3 and GM-CSF have overlapping but distinct hematopoietic activities, and suggest a potential role for the clinical application of combined IL-3/GM-CSF therapy.     

Low plasma granulocyte-macrophage colony stimulating factor is an indicator of poor prognosis in sepsis

OBJECTIVE: Monocyte dysfunction has been shown to be associated with adverse consequences in septic patients. The cytokine growth factor granulocyte-macrophage colony stimulating factor (GM-CSF) may be required for optimal monocyte function in these patients. The current study investigates whether plasma GM-CSF levels were significantly different in septic patients and whether there was an association with prognosis. DESIGN: Plasma samples were collected from all septic patients from day 1 of the diagnosis of sepsis for 3 days. Healthy volunteer plasma served as control samples. A novel enzyme-linked immuno-adsorbent assay was developed with suitable sensitivity for detection of GM-CSF in patient and normal plasma. APACHE II score, age, sex and outcome were determined for all patients. SETTING: A single centre study at the Royal Liverpool University Hospital in a medico-surgical 13 bed intensive care unit. PATIENTS: All septic patients (n = 53) fulfilling the criteria of the APCC for the diagnosis of sepsis, were recruited for the study with informed consent from day 1 of the diagnosis of sepsis and plasma GM-CSF measured on three consecutive days. Patients were excluded from the study if on immunosuppressive therapy. Normal healthy volunteers (n = 33) were included in the study to serve as controls. RESULTS: Plasma GM-CSF levels were statistically significantly depressed in patients who died compared with those who survived, who had levels comparable with healthy controls. CONCLUSIONS: The results indicate that low plasma GM-CSF is associated with adverse consequences for septic patients. The measurement of GM-CSF in the plasma of septic patients merits further study for use as a prognostic marker and also to identify the type of immunotherapy the patient may benefit from.     

同剂量集落刺激因子两种治疗方法的疗效与护理

目的分析同剂量粒细胞集落刺激因子（G—CSF）两种治疗方法的疗效及总结护理方法，指导临床合理应用药物。方法随机选择220例化疗后门细胞减少患者，分为治疗组和对照组各110例，治疗组针刺加血海穴位注射G—CSF，对照组上臂三角肌皮下注射相同剂量G—CSF，定期复查血常规，了解白细胞变化情况。结果治疗组白细胞升至正常水平所需的时间、白细胞维持正常时间明显优于对照组，两者比较差异有统计学意义（P〈0．05）。结论针刺加血海穴位注射G—CSF治疗化疗引起的自细胞减少疗效明显，操作简便，值得推广。