rhG-CSF治疗小儿中性粒细胞减少症的临床效果
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摘要
目的观察重组人粒细胞集落刺激因子(rhG-CSF)联合利可君治疗小儿中性粒细胞减少症的临床效果。方法将海宁市中心医院2015年12月至2017年12月收治的96例中性粒细胞减少症患儿随机分为对照组和观察组,两组均给予常规治疗。对照组在常规治疗的基础上加用维生素B4、鲨肝醇治疗;观察组在常规治疗的基础上加用rhG-CSF+利可君治疗。比较两组的治疗效果,治疗前后的白细胞、中性粒细胞数量改变情况,观察白细胞、中性粒细胞恢复正常水平所需时间。结果观察组治疗总有效率显著高于对照组(89.58%vs.66.67%,χ~2=7.375,P<0.05)。两组治疗后白细胞计数、中性粒细胞计数显著高于治疗前(t值分别为35.893、25.955、22.864、18.156,均P<0.05),治疗后观察组白细胞计数、中性粒细胞计数均显著高于对照组(t值分别为13.115、7.344,均P<0.05)。观察组白细胞恢复正常时间、中性粒细胞恢复正常时间均显著早于对照组(t值分别为4.752、4.803,均P<0.05)。结论采用rhG-CSF联合利可君治疗小儿中性粒细胞减少症临床效果显著,治疗后患儿白细胞、中性粒细胞数量显著升高,值得临床推广应用。
Objective To observe the clinical effects of recombinant human granulocyte colony-stimulating factor(rhG-CSF)combined with Likejun in the treatment of neutropenia in children.Methods Ninety-six children with neutropenia were randomly divided into control group and observation group,who were treated in Central Hospital of Haining during the period of December2015 to December 2017.Both groups were given conventional treatment.The control group was treated with vitamin B4 and shark liver alcohol on the basis of routine treatment,while the observation group was provided with rhG-CSF plus Likejun on the basis of conventional treatment.The treatment effects and the changes in the number of white blood cells and neutrophils before and after treatment were compared between two groups,and the time required for leukocytes and neutrophils to return to normal levels was observed.Results The total effective rate of the observation group was significantly higher than that of the control group(89.58%vs.66.67%,χ~2=7.375,P <0.05).The white blood cells count and neutrophils counts after treatment in two groups were significantly higher than those before treatment(t value was 35.893,25.955,22.864 and 18.156,respectively,all P<0.05),and those in the observation group were significantly higher than those in the control group(t value was 13.115 and 7.344,respectively,both P<0.05).In the observation group,the recovery time of white blood cells and the restoration time of neutrophils were significantly earlier than those in the control group(t value was 4.752 and 4.803,respectively,both P<0.05).Conclusion The clinical efficacy of rhG-CSF combined with Likejun is significant in the treatment of neutropenia in children.After treatment,the number of leukocytes and neutrophils is significantly increased,which is worthy of clinical application.
Objective To observe the clinical effects of recombinant human granulocyte colony-stimulating factor(rhG-CSF)combined with Likejun in the treatment of neutropenia in children.Methods Ninety-six children with neutropenia were randomly divided into control group and observation group,who were treated in Central Hospital of Haining during the period of December2015 to December 2017.Both groups were given conventional treatment.The control group was treated with vitamin B4 and shark liver alcohol on the basis of routine treatment,while the observation group was provided with rhG-CSF plus Likejun on the basis of conventional treatment.The treatment effects and the changes in the number of white blood cells and neutrophils before and after treatment were compared between two groups,and the time required for leukocytes and neutrophils to return to normal levels was observed.Results The total effective rate of the observation group was significantly higher than that of the control group(89.58%vs.66.67%,χ~2=7.375,P <0.05).The white blood cells count and neutrophils counts after treatment in two groups were significantly higher than those before treatment(t value was 35.893,25.955,22.864 and 18.156,respectively,all P<0.05),and those in the observation group were significantly higher than those in the control group(t value was 13.115 and 7.344,respectively,both P<0.05).In the observation group,the recovery time of white blood cells and the restoration time of neutrophils were significantly earlier than those in the control group(t value was 4.752 and 4.803,respectively,both P<0.05).Conclusion The clinical efficacy of rhG-CSF combined with Likejun is significant in the treatment of neutropenia in children.After treatment,the number of leukocytes and neutrophils is significantly increased,which is worthy of clinical application.
引文
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[9]Coppe A,Nogara L,Pizzuto M S,et al.Somatic mutations activating Wiskott-Aldrich syndrome protein concomitant with RAS pathway mutations in juvenile myelomonocytic leukemia patients[J].Hum Mutat,2018,39(4):579-587.
[10]Zhao S Q,Li J M.G-CSF and Its Receptor inHematonosis[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2015,23(3):871-877.
[11]刘俊,黄远东.头孢吡肟单药治疗肺癌患者中性粒细胞减少伴发热的临床观察[J].实用癌症杂志,2016,31(8):1311-1313.
[12]Bedussi F,Relli V,Faraoni L,et al.Normocytic Normochromic Anaemia and Asymptomatic Neutropenia in a 40-Day-Old Infant Breastfed by an Epileptic Mother Treated With Lamotrigine:Infant’s Adverse Drug Reaction[J].J Paediatr Child Health,2018,54(1):104-105.
[13]Tefferi A,Elliott M,Pardanani A.Chronic neutrophilic leukemia:novel mutations and their impact on clinical practice[J].Curr Opin Hematol,2015,22(2):171-176.
[14]庄红艳,刘珊珊,杜海霞,等.舍曲林致白细胞和中性粒细胞减少[J].药物不良反应杂志,2016,18(3):220-221.
[15]冯卉,马进.双黄连颗粒联合西药治疗对小儿支气管肺炎炎性因子水平的影响[J].中国妇幼健康研究,2017,28(10):1294-1296.
[16]Lei W,Zhou K S,Li Y F.Application of lenalidomide in chronic lymphocytic leukemia[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2014,22(2):565-568.
[17]杨峰.中性粒细胞减少症的临床研究[J].中国实用医药,2016,11(36):88-90.
[18]Denstedt E B.Suspected immune-mediated neutropenia and corticosteroid responsive pancytopenia in a Portuguese water dog[J].Can Vet J,2017,58(1):83-86.
[19]任玉琴.利可君治疗甲亢合并白细胞减少疗效观察[J].临床医药文献杂志,2016,3(19):3913-3914.
[20]Wang A Y,Weiner H,Green M,et al.A phase I study of selinexor in combination with high-dose cytarabine and mitoxantrone for remission induction in patients with acute myeloid leukemia[J].J Hematol Oncol,2018,11(1):4.
[21]Wagner S,Brack E K,Stutz-Grunder E,et al.The influence of different fever definitions on diagnostics and treatment after diagnosis of fever in chemotherapy-induced neutropenia in children with cancer[J].PLoSOne,2018,13(2):e193227.
[2]黄慧强,白冰,高玉环,等.应用聚乙二醇化重组人G-CSF预防淋巴瘤患者化疗后中性粒细胞减少:一项前瞻、多中心、开放性临床研究[J].中华血液学杂志,2017,38(10):825-830.
[3]Langenberg-Ververgaert K,Laxer R M,Punnett A S,et al.Chemotherapy-Colchicine Interaction in a Child with Familial Mediterranean Fever and Hodgkin Lymphoma[J].Mediterr J Hematol Infect Dis,2018,10(1):e2018019.
[4]Chen X,Peng W,Zhang Z,et al.ELANE gene mutation-induced cyclic neutropenia manifesting as recurrent fever with oral mucosal ulcer:a case report[J].Medicine(Baltimore),2018,97(10):e31.
[5]徐兵河,田富国,喻璟瑞,等.聚乙二醇化重组人粒细胞刺激因子预防化疗后中性粒细胞减少的多中心随机对照Ⅲ期临床研究[J].中华肿瘤杂志,2016,38(1):23-27.
[6]Gamaletsou M N,Walsh T J,Sipsas N V.Invasive Fungal Infections in Patients with Hematological Malignancies:Emergence of Resistant Pathogens and New Antifungal Therapies[J].Turk J Haematol,2018,35(1):1-11.
[7]江载芳,申昆玲,沈颖.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:325-328.
[8]杨晟,何小慧,刘鹏,等.聚乙二醇化重组人粒细胞集落刺激因子预防化疗后中性粒细胞减少的有效性分析[J].中国肿瘤临床,2015,(12):626-631.
[9]Coppe A,Nogara L,Pizzuto M S,et al.Somatic mutations activating Wiskott-Aldrich syndrome protein concomitant with RAS pathway mutations in juvenile myelomonocytic leukemia patients[J].Hum Mutat,2018,39(4):579-587.
[10]Zhao S Q,Li J M.G-CSF and Its Receptor inHematonosis[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2015,23(3):871-877.
[11]刘俊,黄远东.头孢吡肟单药治疗肺癌患者中性粒细胞减少伴发热的临床观察[J].实用癌症杂志,2016,31(8):1311-1313.
[12]Bedussi F,Relli V,Faraoni L,et al.Normocytic Normochromic Anaemia and Asymptomatic Neutropenia in a 40-Day-Old Infant Breastfed by an Epileptic Mother Treated With Lamotrigine:Infant’s Adverse Drug Reaction[J].J Paediatr Child Health,2018,54(1):104-105.
[13]Tefferi A,Elliott M,Pardanani A.Chronic neutrophilic leukemia:novel mutations and their impact on clinical practice[J].Curr Opin Hematol,2015,22(2):171-176.
[14]庄红艳,刘珊珊,杜海霞,等.舍曲林致白细胞和中性粒细胞减少[J].药物不良反应杂志,2016,18(3):220-221.
[15]冯卉,马进.双黄连颗粒联合西药治疗对小儿支气管肺炎炎性因子水平的影响[J].中国妇幼健康研究,2017,28(10):1294-1296.
[16]Lei W,Zhou K S,Li Y F.Application of lenalidomide in chronic lymphocytic leukemia[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2014,22(2):565-568.
[17]杨峰.中性粒细胞减少症的临床研究[J].中国实用医药,2016,11(36):88-90.
[18]Denstedt E B.Suspected immune-mediated neutropenia and corticosteroid responsive pancytopenia in a Portuguese water dog[J].Can Vet J,2017,58(1):83-86.
[19]任玉琴.利可君治疗甲亢合并白细胞减少疗效观察[J].临床医药文献杂志,2016,3(19):3913-3914.
[20]Wang A Y,Weiner H,Green M,et al.A phase I study of selinexor in combination with high-dose cytarabine and mitoxantrone for remission induction in patients with acute myeloid leukemia[J].J Hematol Oncol,2018,11(1):4.
[21]Wagner S,Brack E K,Stutz-Grunder E,et al.The influence of different fever definitions on diagnostics and treatment after diagnosis of fever in chemotherapy-induced neutropenia in children with cancer[J].PLoSOne,2018,13(2):e193227.