复方阿胶浆与重组人促红细胞生成素改善化疗相关性贫血临床研究
2017,49(10):123-126
摘要：目的:观察复方阿胶浆与重组人促红细胞生成素在改善恶性肿瘤患者化疗相关性贫血中的效果。方法:将76例已经接受化疗并出现化疗相关性贫血的恶性肿瘤患者随机分为复方阿胶浆组与rhEPO组,复方阿胶浆组给予复方阿胶浆;rhEPO组静脉注射益比奥(注射用重组人促红细胞生成素)。2组均持续治疗6周。治疗开始前和每2周采集清晨空腹静脉血检测血细胞指标红细胞(RBC)、白细胞(WBC)、血小板计数(BPC)及血红蛋白(Hb)浓度以及T淋巴细胞亚群CD3~+、CD4~+和CD8~+,比较分析2组的差异。记录并统计比较2组治疗前后贫血等级分布及治疗过程中的不良反应发生情况。结果:2组WBC水平均升高,且复方阿胶浆组升高趋势更明显,差异均有统计学意义(P<0.01);在42天时,复方阿胶浆组高于rhEPO组,差异有统计学意义(P<0.05)。2组RBC相对于治疗前均升高,呈升高趋势,差异有统计学意义(P<0.01);2组Hb浓度均升高,呈升高趋势,差异有统计学意义(P<0.01)。且rhEPO组RBC及Hb浓度均在14天时高于复方阿胶浆组,差异有统计学意义(P<0.05),在28天和42天时,差异无统计学意义(P>0.05)。2组BPC均升高,呈升高趋势,差异有统计学意义(P<0.01);但组间比较,差异无统计学意义(P>0.05)。2组贫血等级分布情况在治疗前后分别比较,差异均无统计学意义(P>0.05);rhEPO组不良反应出现率13.2%(5/38),复方阿胶浆组无不良反应出现。治疗42天后,复方阿胶浆组T淋巴细胞亚群CD3~+、CD4~+、CD4~+/CD8~+分别与治疗前比较,差异均有统计学意义(P<0.05);且复方阿胶浆组T淋巴细胞亚群CD3~+、CD4~+、CD4~+/CD8~+分别与rhEPO组比较,差异均有统计学意义(P<0.05)。结论:复方阿胶浆改善化疗相关性贫血相对于人重组促红细胞生成素初期见效较慢,但中长期疗效相同,且无不良反应出现,同时可在一定程度上增强患者免疫功能。
关键词：贫血; 化学疗法; 复方阿胶浆; 重组人促红细胞生成素; 免疫功能; T淋巴细胞亚群; 红细胞; 血红蛋白;
Abstract：Objective：To observe the effect of compound E Jiao Jiang and recombinant human erythropoietin in improving chemotherapy-related anemia.Methods：Divided 76 cases of malignancy patients with chemotherapy-related anemia after receiving chemotherapy into compound E Jiao Jiang group and rhEPO group randomly.The compound E Jiao Jiang group was treated with compound preparations of E Jiao Jiang；The rhEPO group was treated with recombinant human erythropoietin for injection，three times a week.The two groups both received treatment for six weeks.Before treatment，and every two weeks after treatment，adopted fasting venous blood in the morning so as to detect serum indexes which include count of erythrocyte，white blood cell and platelet count，hemoglobin(Hb)concentration，T-lymphocyte subsets CD3+，CD4+，and CD8+，compared and analyzed differences of the two groups.Recorded and compared distribution of anemia grade and the adverse reaction of the two groups.Results：Level of white blood cell of both groups were increased，and the increasing trend of the compound E Jiao Jiang group was more obvious，the difference being significant(P＜0.01).In the 42th day of treatment，Level of white blood cell of of the compound E Jiao Jiang group was higher than that of the rhEPO group，the difference being significant(P＜0.01).After treatment，erythrocyte and Hb concentration of both groups were both higher than that before treatment，and were getting higher，differences being significant(P ＜0.01)，and the erythrocyte and Hbconcentration of the rhEPO group were higher than those of the compound E Jiao Jiang group in the 14th day after treatment，the difference being significant(P ＞0.05).while in the 28th day and the 42rd day，the difference being not significant(P＞0.05).Compared with those before treatment，platelet of both groups were getting higher，the difference being significant(P＜0.01)，while there was no significance when comparing the difference of the two group(P＞0.05).After treatment，compared distribution of anemia grade of both groups with that before treatment respectively，there was no significant difference(P＞0.05).Incidence of adverse reaction rate of the rhEPO was 13.1%(5/38)，while there had no adverse reaction in the compound E Jiao Jiang group.After 42 days of treatment，compared T-lymphocyte subsets CD3+，CD4+，and CD4+/CD8+of the compound E Jiao Jiang group with that before treatment respectively，difference being significant(P＜0.05)；differences of T-lymphocyte subsets CD3+，CD4+，and CD4+/CD8+between the two groups also being significant(P＜0.05).Conclusion：Compared with recombinanthuman erythropoietin，efficacy ofcompound E Jiao Jiang in improving chemotherapy-related anemia is less significant at the beginning，while Long-term curative effect of compound E Jiao Jiang is equal to that of recombinant human erythropoietin，with no adverse reaction and immune function improved.
Key words：Anemia；Chemotherapy；Compound E Jiao Jiang；Recombinant human erythropoietin；Immune function；T-lymphocyte subsets；Erythrocyte；Hemoglobin
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