重组人促红细胞生成素治疗胃肠道恶性肿瘤化疗相关性贫血的临床观察
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摘要
目的:观察重组人促红细胞生成素治疗胃肠道恶性肿瘤相关性贫血的有效性及安全性。方法:选取胃肠道恶性肿瘤化疗后贫血的80例患者,随机分成两组,每组40例。治疗组给予重组人促红细胞生成素及铁剂进行治疗;对照组仅给予铁剂治疗。观察两组的血红蛋白和红细胞变化以及KPS评分和不良反应发生情况。结果:治疗组与对照组临床有效率分别为97.5%和25%,治疗组显著高于对照组(P<0.05)。治疗4周后,治疗组血红蛋白[(136±12.25)g·L~(-1)]及血细胞比容[(36.87±5.12)]与对照组血红蛋白[(90.60±12.26)g·L~(-1)]及血细胞比容[(26.35±3.28)]比较,差异有统计学意义(P<0.05)。治疗组疗后KPS评分较对照组显著提高,表明患者生活质量明显改善(P<0.05)。治疗组与对照组各有1例患者发生血压升高,差异无统计学意义(P>0.05)。结论:重组人促红细胞生成素治疗胃肠道恶性肿瘤患者化疗后相关性贫血的疗效好,贫血纠正快,能够保证化疗正常进行,且不良反应发生率低,值得临床应用。
Objective: To evaluate the efficacy and safety of recombinant human erythropoietin( rh EPO)in the treatment of chemotherapy-induced anemia in patients with gastrointestinal cancer. Methods: Eighty patients with bone marrow supression after chemotherapy for gastrointestinal malignant tumor were divided into two groups by random number table according to their conditions. The treatment group was treated with recombinant human erythropoietin and iron preparations,while the control group only received iron preparations. The changes of hemoglobin,red blood cells,KPS score and adverse reactions were observed. Results: The clinical effective rates of the treatment group and the control group were 97. 5% and 25%,respectively,for which the treatment group was statistically significantly higher than the control group( P < 0. 05). After 4 weeks of treatment,the hemoglobin[( 136 ± 12. 25) g·L~(-1)] and hematocrit [( 36. 87 ± 5. 12) ] of the treatment group had statistically significant difference with those of the control group [( 90. 60 ± 12. 26) g·L~(-1) and( 26. 35 ± 3. 28) ]( P < 0. 05). The KPS score was significantly im-proved after treatment compared between the two groups,which showed that the quality oflife of patients improved,and the two groups had statistical significance( P < 0. 05). There was 1 case of elevated blood pressure in the treatment group and the control group respectively,but the difference was not statistically significant( P > 0. 05). Conclusion: Recombinant human erythropoietin can effectively correct chemotherapyinduced anemia in patients with gastrointestinal malignancies rapidly,thus ensure the normal chemotherapy,and the incidence of adverse reactions is low. It is worthy of clinical application.
Objective: To evaluate the efficacy and safety of recombinant human erythropoietin( rh EPO)in the treatment of chemotherapy-induced anemia in patients with gastrointestinal cancer. Methods: Eighty patients with bone marrow supression after chemotherapy for gastrointestinal malignant tumor were divided into two groups by random number table according to their conditions. The treatment group was treated with recombinant human erythropoietin and iron preparations,while the control group only received iron preparations. The changes of hemoglobin,red blood cells,KPS score and adverse reactions were observed. Results: The clinical effective rates of the treatment group and the control group were 97. 5% and 25%,respectively,for which the treatment group was statistically significantly higher than the control group( P < 0. 05). After 4 weeks of treatment,the hemoglobin[( 136 ± 12. 25) g·L~(-1)] and hematocrit [( 36. 87 ± 5. 12) ] of the treatment group had statistically significant difference with those of the control group [( 90. 60 ± 12. 26) g·L~(-1) and( 26. 35 ± 3. 28) ]( P < 0. 05). The KPS score was significantly im-proved after treatment compared between the two groups,which showed that the quality oflife of patients improved,and the two groups had statistical significance( P < 0. 05). There was 1 case of elevated blood pressure in the treatment group and the control group respectively,but the difference was not statistically significant( P > 0. 05). Conclusion: Recombinant human erythropoietin can effectively correct chemotherapyinduced anemia in patients with gastrointestinal malignancies rapidly,thus ensure the normal chemotherapy,and the incidence of adverse reactions is low. It is worthy of clinical application.
引文
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[13]汤辉.促红细胞生成素治疗胃癌相关性贫血患者的临床效果探究[J].药品评价,2017,14(17):45-48.
[14]汤月良.胃肠肿瘤外科手术的治疗效果诊治分析[J].中外医学研究,2013,4(26):26-27.
[15]刘维芳,毛金燕,姚卫东.替吉奥联合奥沙利铂治疗晚期消化道肿瘤不良反应的护理[J].中国临床护理,2013,5(5):425-426,435.
[16]尉慧凯,安宁,张献清,等.肿瘤相关性贫血研究进展[J].国际肿瘤学杂志,2015,42(3):238-240.
[17]祁亚平,马洪涛.促红细胞生成素治疗中重度新生儿缺氧缺血性脑病的临床疗效观察[J].中国医药指南,2013,11(11):590-591.
[2]于皆平,沈志祥,罗和生,等.实用消化病学[M].北京:科学出版社,2007:317-353.
[3]莫明秀,罗光辉.甘露聚糖肽联合腹腔内区域性温热化疗胃肠道肿瘤的临床研究[J].今日药学,2011,21(3):180-183,196.
[4]BERMEJO F,GARCA-LPEZ S.A guide to diagnosis of iron deficiency and iron deficiency anemia in digestive diseases[J].World J Glastroenterol,2009,15(37):4638-4643.
[5]INAL A,KAPLAN MA,KUUKONER M,et al.Prognostic factors in first-line chemotherapy treated metastatic gastric cancer patients:a retrospective study[J].Asian Pac J Cancer Prev,2012,13(8):3869-3872.
[6]文建国,冯锦锦.促红细胞生成素的研究进展和临床应用[J].郑州大学学报(医学版),2015,50(6):733-736.
[7]史文涛,侯永芳,叶小飞,等.我国药品不良反应自发呈报系统中信号强度分级阈值的探索[J].药物流行病学杂志,2015,24(8):466-469.
[8]姜永生,王芙蓉.452例恶性肿瘤患者贫血状况及影响因素分析[J].中国医院药学杂志,2012,32(20):1685-1687.
[9]张霞,曾泗宇,石卫民.重组人促红素治疗恶性肿瘤伴贫血的药效观察[J].河北医学,2015,21(9):1468-1471.
[10]张佳,徐理,高建飞.促红细胞生成素联合复方阿胶浆治疗癌性贫血的疗效观察[J].药品评价,2013,10(10):21-23.
[11]TONIA T,METTLER A,ROBERT N,et al.Erythropoietin or darbepoetin for patients with cancer[J].Cochrane Database Syst Rev,2012,12:CD003407.
[12]吴付兵,王星,王康霞,等.促红细胞生成素对胃癌相关性贫血患者的疗效[J].现代肿瘤医学,2015,23(2):241-243.
[13]汤辉.促红细胞生成素治疗胃癌相关性贫血患者的临床效果探究[J].药品评价,2017,14(17):45-48.
[14]汤月良.胃肠肿瘤外科手术的治疗效果诊治分析[J].中外医学研究,2013,4(26):26-27.
[15]刘维芳,毛金燕,姚卫东.替吉奥联合奥沙利铂治疗晚期消化道肿瘤不良反应的护理[J].中国临床护理,2013,5(5):425-426,435.
[16]尉慧凯,安宁,张献清,等.肿瘤相关性贫血研究进展[J].国际肿瘤学杂志,2015,42(3):238-240.
[17]祁亚平,马洪涛.促红细胞生成素治疗中重度新生儿缺氧缺血性脑病的临床疗效观察[J].中国医药指南,2013,11(11):590-591.