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目的评价促红细胞生成素(epoetin alfa,EPO)对接受化疗的肿瘤患者血红蛋白(hemoglobin,Hb)、输血需求以及生存质量(quality of life,QOL)的影响。方法将79例Hb≤12.0g/dL的恶性肿瘤患者随机分为两组:治疗组接受EPO8000U/次,皮下注射,每周3次,持续8周(EPO组);对照组采用最佳支持治疗(best supportive care,BSC)(BSC组)。观察两组化疗期间Hb变化、输血需求、QOL及不良反应情况。结果在整个治疗过程中EPO组的平均Hb水平保持在12.0g/dL以上,而BSC组的Hb下降。EPO组的Hb反应率为53.8%,明显好于BSC组7.5%(P<0.0001)。EPO组和BSC组的输血需求分别为7.7%、30%(χ2=6.388,P<0.05)。8周时,EPO组的FACT-An贫血及乏力平均分数变化分别为(2.16±12.84)、(3.58±10.52),BSC组分别为(-4.43±13.42)、(-5.34±11.14)(P<0.0001)。两组的不良反应相似。结论EPO能使接受化疗的肿瘤患者保持Hb水平、减少输血需求、提高生存质量。
Objective To evaluate the effect of epoetin alfa (EPO) on hemoglobin (Hb), blood transfusion requirements and quality of life (QOL) in patients undergoing chemotherapy. Methods 79 patients with Hb≤12.0g / dL were randomly divided into two groups: the treatment group received EPO 8000U / time, subcutaneous injection three times a week for 8 weeks (EPO group), and the control group received the best supportive therapy (best supportive care, BSC) (BSC group). Hb changes during chemotherapy, blood transfusion requirements, QOL and adverse reactions were observed. Results The average Hb level in the EPO group remained above 12.0 g / dL throughout the course of treatment, while Hb in the BSC group decreased. The Hb response rate in the EPO group was 53.8%, significantly better than that in the BSC group (P <0.0001). Blood transfusions for the EPO and BSC groups were 7.7% and 30%, respectively (χ2 = 6.388, P <0.05). At 8 weeks, the changes of FACT-A anemia and fatigue in the EPO group were (2.16 ± 12.84) and (3.58 ± 10.52), respectively, and those in the BSC group were (-4.43 ± 13.42 and 5.34 ± 11.14, P < 0.0001). Adverse reactions in both groups were similar. Conclusions EPO can maintain the level of Hb in patients undergoing chemotherapy and reduce the need for blood transfusion and improve the quality of life.