rhG-CSF对儿童慢性再生障碍性贫血促造血及抗感染作用

目的探讨重组人粒细胞集落刺激因子（rhG-CSF）对儿童慢性再生障碍性贫血（CAA）防治感染、促进造血功能恢复的作用。方法将本院收治的40例CAA病儿随机分为2组,对照组应用环孢素、达那唑及中药治疗,治疗组在对照组基础上加用rhG-CSF（3μg/kg皮下注射,每周1次,待中性粒细胞≥1×109/L时停止皮下注射,〈1×109/L时再次皮下注射rhG-CSF）。疗程为3个月。检查血常规、骨髓常规,临床观察感染发生率、感染例次及感染严重程度。结果治疗1周时,治疗组中性粒细胞数量较治疗前、同期对照组均明显升高（t=40.00、41.30,P〈0.05）;治疗3个月时,治疗组中性粒细胞≥1×109/L例次明显高于对照组（t=6.60,P〈0.05）,外周血白细胞、中性粒细胞、血红蛋白、血小板较治疗前及同期对照组明显增高（t=3.66~60.74,P〈0.05）,骨髓增生活跃程度、粒系增生程度及巨核细胞个数明显高于治疗前及同期对照组（χ2=16.94、6.67,t=2.38~100.00,P〈0.05）,感染发生率、感染次数及抗生素应用天数均较对照组明显减少（χ2=5.58,t=2.42、2.99,P〈0.05）。结论 CAA治疗过程中,加用rhG-CSF能迅速升高中性粒细胞数量,减少感染次数,减轻感染程度,促进造血功能恢复。

THE EFFECTS OF RECOMBINANT HUMAN GRANULOCYTE COLONYTE STIMULATING FACTOR ON HEMATOGENESIS AND ANTI-INFECTION IN CHILDREN WITH CHRONIC APLASTIC ANEMIA

Objective To explore the effects of recombinant human granulocyte colonyte stimulating factor（rhG-CSF） on infection prevention and promotion of hematogenesis in children with chronic aplastic anemia（CAA）. Methods Forty CAA children were equally divided into control group and treatment group in random.The children in control group were treated with cyclosporine,danazoI,and Chinese medicine;those in treatment group were given subcutaneous injection of rhG-CSF（3 μg/kg,once a week,the injection discontinued when neutrophil was ≥1×109/L,and reinjection of rhG-CSF was carried out when neutrophil was 1×109/L）,the course of treatment was three months.Blood routine,and bone marrow picture were detected regularly,the incidence,cases,and severity of infection were observed. Results At one week of the treatment,the numbers of neutrophils increased versus before therapy,and also higher than that of the control（t=40.00,41.30;P〈0.05）;At three months of treatment,the case-time of neutrophil count of ≥1×109/L in treatment group was higher than control group（t=6.60,P〈0.05）;and peripheral blood leucocyte,neutrophil,hemoglobin,and platelet were significantly increased than before treatment and control group（t=3.66-60.74,P〈0.05）.Bone marrow hyperplasia,granulocyte hyperplasia,and number of megakaryocyte in the treatment group were increased greater than before treatment and than the control,the infection rate,cases of infection,and course of anti-infection treatment in the treatment group were remarkably lower than that of the control group（χ2=5.58;t=2.42,2.99;P〈0.05）. Conclusion In the course of CAA treatment,application of rhG-CSF can promptly elevate the neutrophil count,reduce infection rate,relieve the severity of infection and recover the function of hematogenesis.