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目的:比较常规剂量重组人促红细胞生成素(rHuEPO)与大剂量rHuEPO治疗癌性贫血的疗效。方法:将血红蛋白(Hb)≤10.0g/dL的癌性贫血病人随机分为常规剂量rHuEPO组(A组:10000U/次,qod,8周)与大剂量rHuEPO组(B组:40000U/次,qod×3次,然后1次/周×7周),治疗不到8周者至Hb≥13.5g/dL时停药。每周复查血常规,rHuEPO治疗2周后补充铁剂(力蜚能胶囊150mg口服,1次/d)。结果:治疗开始的8周后评价疗效,A、B2组有效率分别为55.7%、73.3%,P<0.05;在治疗的第2、4、8周,B组平均Hb水平高于A组,差异均有显著性,在治疗的第6周2组差异无显著性。与治疗前基础水平相比,B组在治疗的第2周Hb即显著升高[(10.15±1.1)对(9.30±0.91),P<0.05)],而A组这种差异最早出现在第4周[(9.85±1.33)对(9.26±0.95),P<0.05)];另外,治疗的第2、4、6、8周,Hb的平均水平B组均高于A组(P<0.05)。2组未见有明显的副作用发生。结论:大剂量rHuEPO治疗癌性贫血的疗效要好于常规剂量,升高Hb的速度也比常规剂量要快,副作用少且可以耐受。
OBJECTIVE: To compare the efficacy of rHuEPO with high-dose rHuEPO in the treatment of cancerous anemia. Methods: Patients with cancerous anemia with hemoglobin (Hb) ≤10.0g / dL were randomly divided into rHuEPO group (A group: 10000U / qd, 8weeks) and high dose rHuEPO group (B group: 40000U / qod × 3 times, then 1 time / week × 7 weeks), treatment less than 8 weeks to Hb ≥ 13.5g / dL withdrawal. Weekly review of blood routine, rHuEPO treatment after 2 weeks of iron supplementation (force Fei Capsule 150mg orally, 1 / d). Results: After 8 weeks of treatment, the effective rates in group A and group B2 were 55.7% and 73.3%, respectively, P <0.05; at the 2nd, 4th and 8th week of treatment, the average Hb level in group B was higher than that in group A, The differences were significant, there was no significant difference between the two groups in the 6th week of treatment. Compared with the baseline level before treatment, Hb in group B increased significantly at the second week of treatment [(10.15 ± 1.1) vs (9.30 ± 0.91, P <0.05)], while the difference between group A and group B (9.85 ± 1.33 vs 9.26 ± 0.95, P <0.05). In addition, the average level of Hb in group B at 2, 4, 6 and 8 weeks after treatment was higher than that in group A (P <0.05 ). No obvious side effects occurred in 2 groups. CONCLUSIONS: High-dose rHuEPO is more effective than conventional doses in the treatment of cancer-related anemia and the rate of Hb elevation is also faster than conventional doses with few side effects and tolerability.