71例肿瘤化疗致3~4级骨髓抑制的分析

目的：了解肿瘤科化疗致3~4级骨髓抑制不良反应的特点及相关因素，为临床合理用药提供参考。方法：选取某院2016年因化疗致3~4级骨髓抑制的住院肿瘤患者71例，分别从性别与年龄、药物种类、疾病类型、骨髓抑制类型及时间特点、化疗周期对抑制率的影响等多个因素进行回顾性分析。结果：3~4级骨髓抑制患者中男性多于女性，以41~60岁的中年人为主；药物以多西他赛、顺铂、吉西他滨为主，骨髓抑制的外周血象主要表现为白细胞及血小板下降；头颈部肿瘤所占比例最高，为67.7%；三系细胞开始下降时间和低值持续时间各不相同；白细胞及血小板最低值的发生率在化疗第4周期达到最大。结论：3~4级骨髓抑制的发生与多种因素有关，临床药师应该做好不良反应的报告和监测工作，减少反应的发生。

Analysis of chemotherapy induced grade Ⅲ-Ⅳ bone marrow suppression in 71 patients

OBJECTIVE To investigate the characteristics and related factors of grade Ⅲ-Ⅳ bone marrow suppression induced by antitumor drugs and provide references to the clinical rational use of drugs.METHODS Retrospective analysis was conducted on 71 case of grade Ⅲ-Ⅳ bone marrow suppression patients in a hospital in 2016, in terms of the patient gender and age, categories of drug, types of disease, types and time characteristics of bone marrow suppression, and relationship between suppression rate and chemotherapy cycle.RESULTS Bone marrow suppression induced by chemotherapy occurred in more female than male, mostly in middle aged patients of 41-60 years old. Most of the patients were treated with docetaxel, DDP and gemcitabine. The major peripheral manifestations were reduced leucocytes and platelets. Head and neck cancers took the highest proportion accounting for 67.7%. Three cell lines decreased at different onset times for varied durations. Leucocyte and platelet counts reached the minimal values in the 4^th cycle of chemotherapy.CONCLUSION Grade Ⅲ-Ⅳ bone marrow suppression is related with many factors. Clinical pharmacist should attach great importance to the reporting and monitoring to reduce adverse drug reactions.