基因重组人粒细胞集落刺激因子治疗急性粒细胞缺乏症10例

急性粒细胞缺乏症是一种严重的内科急症,常合并重症感染败血症、肝功能损害等,近年来临床有增加趋势。我院１９９４－１９９６年应用基因重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）治疗１０例,除一例三日内死于顽固性左心衰竭,肺水肿、甲亢危象外,余均抢救成功。现...     

重组人粒细胞集落刺激因子治疗骨髓抑制

重组人粒细胞集落刺激因子强化疗引起的骨髓抑制１６例，年龄１５－５４岁。治疗组用ｒＨＧ－ＣＳＦ７５－１５０μｇ．ｓｃ，ｑｄ；采用自身对照法，对照组用抗甲素片，１０ｍｇ，ｐｏ，ｔｉｄ。结果：治疗组白细胞和中性粒细胞数升高明显多于对照组。     

重组人粒细胞－集落刺激因子预防肺癌化疗期感染的效果

目的总结重组人粒细胞－集落刺激因子（ｒｈＧ－ＣＳＦ）预防肺癌化疗期感染的效果。方法回顾分析１６３例（３０８例次）肺癌患者化疗期辅用或不用ｒｈＧ－ＣＳＦ中性粒细胞恢复和感染情况。结果化疗期用ｒｈＧ－ＣＳＦ患者（Ｇ－ＣＳＦ组）感染率（５４／２１７，２５％）明显低于非Ｇ－ＣＳＦ组（５１／９１，５６％）（Ｐ＜０．００５）；Ｇ－ＣＳＦ组化疗期中性粒细胞减少的发生率明显低于非Ｇ－ＣＳＦ组（Ｐ＜０．００５），并且Ｇ－ＣＳＦ组中性粒细胞减少（＜１．０×１０９·Ｌ－１）持续时间（３天）比非Ｇ－ＣＳＦ组（４天）缩短一天（Ｐ＜０．００１）。但两组感染治疗效果差异无显著性（Ｐ＞０．０５）。结论ｒｈＧ－ＣＳＦ通过促进中性粒细胞增殖，缩短化疗期中性粒细胞减少持续时间，不仅能增加肺癌患者对化疗的耐受性，而且还能预防化疗期感染，同时又可提高患者的生活质量。     

极小剂量重组人粒细胞集落刺激因子治疗骨髓增殖异常综合征17例

我们用极小剂量重组人粒细胞集落刺激因子（rhG-CSF）治疗骨髓增殖异常综合征（MDS）17例,有效地提高了病人的粒细胞水平,减少了感染机会,费用适中。现将结果报道如下:1 方法和材料1.1 临床资料 17例病人均为我院1993年8月～1995年2月期间住院病人,男10例,女7例,中位年龄48岁,病程3个月～2年,均符合1986年全国第1次血细胞学术交流会诊断及分型标准,其中RA6例,RAS2例,RAEB9例。     

应用粒细胞集落刺激因子致外周血和骨髓类白血病反应

人类粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）是一种对粒细胞增殖分化、成熟具有调节功能的细胞生长因子。近年来,ｒｈＧ－ＣＳＦ广泛用于各种原因引起的骨髓增生低下,取得了较满意的疗效。但在临床应用过程中,有引起类白血病反应的现象,甚至误诊为急性白血病或白血病复发。１　临床资料１．１　一般资料骨髓增生低下７例,男３例,女４例;年龄２０～６８岁,平均３６．６岁。导致增生低下的原因：急性白血病化疗后２例;恶性淋巴瘤化疗后１例;ＭＤＳ－ＲＡＥＢ２例;ＭＤＳ－ＲＡＥＢＴ化疗后、粒细胞缺乏症各１例。上述７例临床上均有…     

自体骨髓移植后用粒细胞集落刺激因子致类白血病现象二例

自体骨髓移植后用粒细胞集落刺激因子致类白血病现象二例谢彦晖谢毅阎金玉刘均立重组人粒细胞集落刺激因子（ｒｈＧ－ＣＳＦ）是近年来在临床推广使用的一种造血因子，具有白细胞动员和促进粒细胞增殖作用。我们发现在自体骨髓移植后使用ｒｈＧ－ＣＳＦ，不仅引起了白细胞...     

单用或联用氟康唑和粒细胞集落刺激因子对血液病区感染的预防

单用或联用氟康唑和粒细胞集落刺激因子对血液病区感染的预防谢彦晖郑少青闫金玉陈勤奋谢毅林果为我们用氟康唑和粒细胞集落刺激因子（Ｇ－ＣＳＦ）对血液病区感染进行预防，多因素分析结果如下。一、研究对象：１９９４年７、８月份血液普通病房患者共３４例为第１组，男...     

基因重组人粒细胞集落刺激因子防治肺癌患者化疗反应

采用随机分组、自身交叉对比的方法，观察了基因重组人粒细胞集落刺激因子（Ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｇｒａｎｕｌｏｃｙｔｅｃｏｌｏｎｙ－ｓｔｉｍｕｌａｔｉｎｇｆａｃｔｏｒ，ｒｈＧ－ＣＳＦ）对肺癌患者化疗（卡铂＋鬼臼乙叉甙，即ＣＥ化疗方案）所致白细胞和中性粒细胞减少的防治作用及毒副反应。全组共２２例，随机分成Ａ、Ｂ两组（各１１例）。Ａ组第一周期化疗后加用ｒｈＧ－ＣＳＦ，第二周期单用化疗；Ｂ组第一周期单用化疗，第二周期化疗后加用ｒｈＧ－ＣＳＦ。结果表明，ｒｈＧ－ＣＳＦ可以明显减轻化疗过程中白细胞和中性粒细胞下降的程度及其发生率，缩短白细胞和中性粒细胞降至正常值以下的持续时间，促进其早日恢复，使化疗可以如期进行。ｒｈＧ－ＣＳＦ副反应轻微，安全可靠。     

粒细胞集落刺激因子治疗系统性红斑狼疮

粒细胞集落刺激因子治疗系统性红斑狼疮王振刚在系统性红斑狼疮（ＳＬＥ）的治疗中，由于疾病本身或应用环磷酰胺（ＣＴＸ）引起的粒细胞减少症及由此而继发的感染，常常不得不中断治疗而影响疗效。我们将粒细胞集落刺激因子（Ｇ－ＣＳＦ）应用于上述情况，取得了良好效果...     

Changes in lung function in patients with newly-diagnosed tuberculosis during treatment with short courses of controlled drug therapy]

In 54 new cases of tuberculosis, VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, PaO2, PaCO2 were measured before, during, and after a short-term intensive controlled chemotherapy. Lung function improved in 57.4% of patients and deteriorated in 22.2%. There was a combination of better and worse lung function in 7.4%. The direction of functional changes depended on the form of tuberculosis, the extent of a tuberculous process, the duration and efficiency of chemotherapy.     

Meningeal carcinomatosis in patients with lung cancer]

Of the 1548 patients with primary lung cancer who were admitted to our hospital from January 2001 through March 2005, 37 in whom meningeal carciomatosis was diagnosed on cytologic examination of cerebrospinal fluid or magnetic resonance imaging of the brain and spinal cord were studied retrospectively. The most common histologic type was adenocarcinoma, diagnosed in 70% of those patients. The results of cytologic examination of cerebrospinal fluid were positive in 71%. The time from the date of diagnosis of lung cancer to the date of diagnosis of meningeal carcinomatosis ranged from -2 days to 8 years (median, 407 days). Survival from the date of diagnosis of meningeal carcinomatosis ranged from 10 to 392 days (median, 106 days). Treatment for meningeal carcinomatosis was decided on the basis of the patient's general condition and the contorol status of the primary lesion. Radiotherapy, systemic chemotherapy, and palliative therapy were combined. Gefitinib was most often used for chemotherapy after the onset of meningeal carcinomatosis, and 60% of the patients given gefitinib had stable disease. One of these patients (adenocarcinoma) survived for longer than 1 year. Further investigatons are needed to establish standard treatments, including the use of gefitinib, that can improve the quality of life and prolong the survival of patients with meningeal carcinomatosis.     

Thromboembolism in lung cancer patients]

We reviewed 649 primary lung cancer patients with special reference to the occurrence of thromboembolism. Thirteen episodes of thromboembolism were detected in 12 (1.8%) of the 649. Eight of the 12 were men, and their mean age was 63. Adenocarcinoma was the predominant cell type. Most patients had an advanced stage of the disease, but in some in the cancer was at an early stage. In 5 cases, the finding of thromboembolisms led to diagnosis of the lung cancer (38.5%). Anticoagulant therapy was performed in 9 cases, of which 8 responded without serious complication. We emphasize the importance of anticoagulant therapy as a therapy indicated for thromboembolism in patients with lung cancer.     

晚期肺癌合并肺部感染的临床研究

目的探讨晚期肺癌合并肺部感染的临床特点。方法对近4年收治的130例晚期肺癌合并肺部感染病例的临床资料进行分析。结果本组患者年龄≥60岁、性别为男性、住院天数≥15天、合并基础疾病、外周血白细胞计数<4×109/L、低蛋白血症者易并发肺部感染。当病人出现中度以上发热、血氧饱和度降低时要高度警惕可能合并肺部感染。血CRP、PCT升高可作为肺部感染的炎症预测指标。革兰氏阴性杆菌(67.23%)是肺部感染的最常见致病菌,存在多药耐药,根据药敏试验结果及时调整抗生素的使用。结论晚期肺癌合并肺部感染存在多种危险因素,应加强预防,要重视病原学检测及药敏试验,合理使用抗生素。     

肺癌患者耶氏肺孢子菌的隐性感染研究

目的检查肺癌患者的耶氏肺孢子菌(Pneumocystisjiroveci,P.jiroveci)的隐性感染情况,为癌症患者的化疗、肺孢子菌肺炎的预防提供参考依据。方法收集了50份未接受化疗的肺癌患者的肺癌旁肺组织标本及其相关信息,采用Giemsa、GMS病原学染色法和PCR扩增技术检测该组患者P.jiroverci的自然隐性感染率。并对感染者的年龄及性别进行了相关性分析。结果Giemsa、GMS、PCR三种方法检测到P.jiroveci的隐性感染率分别为Giemsa法2%;GMS法10%;PCR法为16%。X2检验结果显示三种不同检测方法的检测结果具有显著性差异(P<0.05)。对患者的年龄及性别的相关性分析结果表明,该组患者的P.jiroveci隐性感染情况无性别及年龄相关性。结论肺癌患者携带P.jroveci病原体,感染率为16%,提示这类患者存在发生肺孢子菌肺炎和成为传染源的潜在危险。对比本实验采用的三种检测方法,以PCR技术较为敏感。     

Association of specific metastatic organs with the prognosis and chemotherapeutic response in patients with advanced lung cancer

BackgroundThis study was performed to investigate the influence of specific metastatic organs on the prognosis and therapeutic effect in patients with advanced lung cancer.MethodsWe retrospectively analyzed 400 patients with pathologically diagnosed advanced lung cancer to determine the association of the patients’ metastatic status with their prognoses and responses to first-line therapy. Metastases within the chest cavity (pulmonary metastasis, pleural effusion, and pericardial effusion) were counted as one organ.ResultsThe numbers of metastatic organs in the patients were as follows: one (n=199 patients), two (n=99), three (n=61), and four or more (n=41). A multivariate analysis showed that liver and muscle metastases were independently associated with shorter overall survival (median of 207 and 120 days, respectively) and shorter progression-free survival (median of 125 and 53 days, respectively). Chest cavity, bone, brain, and lymph node metastases were not associated with survival. The presence of either muscle or skin metastasis was associated with a lower response rate to first-line therapy than was the absence of each metastasis (14.3% vs. 49.4% and 11.1% vs. 48.9% in patients with vs. without muscle or skin metastasis, respectively).ConclusionsMuscle and liver metastases were associated with poor outcomes. Muscle and skin metastases were associated with a lower response rate to treatment. For patients with advanced lung cancer, oncologists should select treatment strategies considering the patients’ metastatic statuses as well as other clinical characteristics.     

肺癌患者医院感染调查分析

目的对肺癌患者发生医院感染的状况进行调查分析。方法对126例肺癌患者发生医院感染的状况进行分析。结果 126例肺癌患者中分离出病原菌148株,病原菌以革兰氏阴性杆菌为主(62.84%),革兰氏阳性杆菌(29.73%),真菌(7.43%);细菌的耐药性普遍较高;感染的相关因素有:年龄、住院时间、肺癌临床分期、侵袭性操作、放疗/化疗、抗生素的使用、免疫抑制剂或激素、伴有基础疾病。结论肺癌患者医院感染病原菌以革兰氏阴性杆菌为主,病原菌常为多药耐药。合理控制院内感染的相关因素,对指导临床合理用药具有重要意义。     

肺癌患者深部真菌感染主要病原菌RAPD分析

目的对肺癌患者深部真菌感染的主要病原菌进行研究。方法用随机扩增多态性DNA分析技术对肺癌患者深部真菌感染的主要病原菌基因进行分析。结果两条随机引物扩增的两组白念珠菌菌株之间条带的数量和片段大小存在差异,即使带型完全一致的菌株,有些片段的EB显色强度也有区别,但没有统计学意义。结论肺癌患者深部真菌感染白念珠菌的基因在疾病的发生、发展过程中基本稳定。