PEG-rhG-CSF预防卵巢癌、宫颈癌化疗中性粒细胞缺乏的临床研究

目的:探讨应用聚乙二醇化重组人粒细胞集落刺激因子(PEG-rhG-CSF)对卵巢癌、宫颈癌化疗患者粒细胞减少的影响，并观察不良反应。方法:选择本院2015年4月至2017年6月卵巢癌、宫颈癌患者136例，随机分为对照组（68例）和研究组（68例），对照组应用rhG-CSF，研究组应用PEG-rhG-CSF，两组均化疗两个周期，评估患者两个周期不同时间血常规绝对中性粒细胞计数值（ANC）水平、ANC不同数量发生率和持续时间以及不良反应。结果:研究组患者第一个化疗周期第5 d、第7 d、第10 d和第14 d 及第二个化疗周期第3 d、第5 d、第7 d、第10 d和第14 d血ANC分别为（3.19±0.32）×109/L、（1.93±0.35）×109/L、（2.08±0.39）×109/L、（2.11±0.36）×109/L和（2.79±0.40）×109/L、（2.44±0.33）×109/L、（1.68±0.34）×109/L、（1.71±0.37）×109/L、（1.92±0.34）×109/L，均高于对照组，差异具有统计学意义(P＜0.05)。研究组患者第一个和第二个化疗周期ANC＜1.5×109/L、ANC＜1.0×109/L和ANC＜0.5×109/L发生率分别为23.53%（16/68）、8.82%（6/68）、2.94%（2/68）和29.41%（20/68）、10.29%（7/68）、5.88%（4/68），均低于对照组，差异具有统计学意义(P＜0.05)。研究组患者第一个和第二个化疗周期ANC＜1.5×109/L、ANC＜1.0×109/L和ANC＜0.5×109/L持续时间分别为（3.50±0.18）d、（2.17±0.23)d、（2.06±0.29）d和（4.08±0.22）d、（4.62±0.29）d、（4.11±0.24）d，均短于对照组，差异具有统计学意义(P＜0.05)。研究组中、重度不良反应总发生率为10.29%（7/68），低于对照组23.53%（16/68），差异有统计学意义(P＜0.05)。结论:应用PEG-rhG-CSF能够有效预防卵巢癌、宫颈癌化疗患者粒细胞减少，不良反应显著降低，值得临床推广应用。

The clinical study on PEG-rhG-CSF preventing forneutrophil deficiency of ovarian cancer and cervical cancer chemotherapy

Objective:To explore the effect of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) on neutrophil deficiency in patients with ovarian and cervical cancer chemotherapy and to observe adverse reactions.Methods:136 patients with ovarian and cervical cancer from we April 2015 to June 2017 in this hospitalwere selected and randomly divided into control group (68 cases) and study group (68 cases).The control group was treated with rhG-CSF and the study group was treated with PEG- rhG-CSF,two chemotherapy cycle.Assessed two chemotherapy cycle for the blood absolute neutrophil count (ANC) levels,the incidence and duration of different ANC counts,and adverse events at different times.Results:ANC level of study group at 5 d，7 d,10 d,and 14 d during the first chemotherapy cycle and at 3 d,5 d，7 d,10 d,and 14 d during second chemotherapy cycle were (3.19±0.32)×109/L,(1.93±0.35)×109/L,(2.08±0.39)×109/L,(2.11±0.36)×109/L and (2.79±0.40)×109/L,(2.44±0.33)×109/L,(1.68±0.34)×109/L,(1.71±0.37)×109/L,(1.92±0.34)×109/L respectively,which were higher than the control group,and the difference was statistically significant (P＜0.05).The incidence of ANC<1.5×109/L,ANC<1.0×109/L and ANC<0.5×109/L in the study group during the first and second chemotherapy cycle was 23.53%(16/68),8.82%(6/68),2.94%(2/68) and 29.41%(20/68),10.29%(7/68),5.88%(4/68),lower than the control group,and the difference was statistically significant (P＜0.05).The durations time of ANC<1.5×109/L,ANC<1.0×109/L and ANC<0.5×109/L in the study group during the first andsecond chemotherapy cycle were (3.50±0.18)d,(2.17±0.23)d,(2.06±0.29)d and(4.08±0.22)d,(4.62±0.29)d,(4.11±0.24)d respectively,shorter than the control group,and the difference was statistically significant (P＜0.05).The overall incidence of moderate and severe adverse reactions in the study group was 10.29%(7/68),which was lower than the control group 23.53% (16/68),the difference was statistically significant (P＜0.05).Conclusion:The use of PEG-rhG-CSF can effectively prevent the neutropenia of ovarian cancer and cervical cancer chemotherapy patients,and the adverse reactions are significantly reduced,which is worthy of clinical application.