Objective To discuss the efficacy and adverse reactions of PEG-rhG-CSF in the prevention of bone marrow suppression induced by cisplatin based chemotherapy in patients with advanced cancer .Methods 92 cases of advanced cancer patients were randomly divided into the control group (n=46) and the observation group(n=46).The 2 groups were treated with combined chemotherapy with cisplatin based chemotherapy ,the blood routine monitoring after the start of chemotherapy ,Ⅰ and higher degree of bone marrow suppression and timely treatment with the process of one cycle of chemotherapy after 48 h at the end of the last cycle of chemotherapy after the observation group were given subcutaneous injection of PEG -rhG-CSF,5μg· kg/once/cycle,the blood routine once ,if continue to increase the degree of bone marrow suppression at Ⅳ replenishment of subcutaneous injection of rhG-CSF 5μg· kg/once/day,the control group was treated with subcutaneous injection of rhG-CSF,5μg· kg/once/day.The 2 groups of patients were in absolute neutrophil value more than 2 ×109 and /or white blood cell count over 4 ×109 disa-bled rhG-CSF.In the course of treatment ,if there was a reduction in febrile neutropenia ,the 2 groups were given antibiotics to pre-vent infection .The adverse reactions of patients were recorded .Results The incidence of the patients in the observation group (43.48%) was lower than that of the control group (63.04%)(P<0.05);The observation group with nausea 11(23.91%), leukopenia 18(39.13%),gastrointestinal reaction 16(34.78%) and nephrotoxicity 16(34.78%) were significantly lower than that of the control group nausea 17(36.95%) neutropenia 29(63.04%),gastrointestinal reactions 23(50.00%) and nephrotox-icity 19(41.30%) (P<0.05).Conclusion PEG-rhG-CSF effectively reduced the degree of myelosuppression caused by cispl-atin combined chemotherapy ,with slight adverse reactions ,and had a good prospect of application .%目的 探讨PEG-rhG-CSF预防晚期癌症患者以顺铂为基础的联合化疗所致骨髓抑制的效果及其不良反应.方法 选择92例晚期癌症患者,按随机数字法分为对照组46例和观察组46例.2组患者均采用以顺铂为基础的联合化疗方案,化疗开始后常规监测血常规.在前一周期化疗过程中出现Ⅰ度及以上骨髓抑制并及时处理后,在下一周期化疗用药结束48 h后观察组予PEG-rhG-CSF皮下注射,5μg·kg/次/周期,隔天化验血常规1次,如果骨髓抑制继续加重达Ⅳ度则补充rhG-CSF皮下注射5μg·kg/次/天;对照组则予rhG-CSF皮下注射,5μg·kg/次/天.2组患者均在中性粒细胞绝对值≥2.0×109和(或)白细胞计数≥4.0×109时停用rhG-CSF.治疗过程中如果出现粒细胞减少性发热则2组患者均按照诊疗常规予抗生素防治感染.详细记录用药后患者的不良反应.结果 观察组患者的中性粒细胞减少的发生率(43.48%)明显低于对照组(63.04%)(P<0.05).观察组患者恶心11例(23.91%)、白细胞下降18例(39.13%)、胃肠道反应16例(34.78%)及肾毒性16例(34.78%)等,不良反应发生率明显低于对照组[恶心17例(36.95%)、白细胞下降29例(63.04%)、胃肠道反应23例(50.00%)及肾毒性19例(41.30%)](P<0.05).结论PEG-rhG-CSF可有效减轻以顺铂为基础联合化疗所致骨髓抑制的程度,不良反应轻微,具有良好的应用前景.
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