目的:探讨采用重组人粒细胞集落刺激因子(rh G-CSF)治疗白细胞减少症的临床效果及机制。方法:选取骨髓增生异常综合征患者60例(A组)、再生障碍性贫血患者60例(B组)、药物性白细胞减少患者60例(C组),均采用rh G-CSF治疗,检测3组患者治疗前外周血中粒细胞集落刺激因子(G-CSF)水平、骨髓单个核细胞G-CSF受体(G-CSFr)表达率以及治疗前后外周血白细胞及中性粒细胞计数增长率。结果:B、C组G-CSF水平显著高于A组(P<0.05),B组G-CSFr表达率低于A、C组(P<0.05);白细胞增长率C组高于A、B组(P<0.05),A组高于B组(P<0.05);中性粒细胞增长率C组高于A、B组(P<0.05),A组高于B组(P<0.05);治疗有效率C组(93.33%)高于A组(73.33%)和B组(51.67%)(P<0.05),A组高于B组(P<0.05);外周血白细胞、中性粒细胞增长率与G-CSF水平无相关性(r=0.116,P=0.518),与G-CSFr正相关(r=0.429,P<0.05)。结论:rh G-CSF治疗骨髓异常增生综合征、再生障碍性贫血和药物性白细胞减少均有一定的效果,但对药物性白细胞减少的效果最优,再生障碍性贫血最差,可能与G-CSFr表达具有一定的关系。 Objective: To investigate the clinical effect and mechanism of rhG-CSF treatment of leucopenia. Methods: 60 patients with myelodysplastic syndrome (group A), 60 patients with aplastic anemia (group B), and 60 patients with drug-induced leukopenia (group C) were treated with rhG-CSF, and 3 The levels of G-CSF in peripheral blood, the expression of G-CSF in bone marrow mononuclear cells and the peripheral blood leucocyte and neutrophil counts before and after treatment were significantly higher than those before treatment. Results: The levels of G-CSF in group B and group C were significantly higher than those in group A (P <0.05). The expression of G-CSF in group B was lower than that in group A and C (P <0.05) (P <0.05). The neutrophil growth rate in group A was higher than that in group A and B (P <0.05), and in group A was higher than that in group B (P <0.05) (93.33%) in treatment group A were higher than those in group A (73.33%) and group B (51.67%) (P <0.05), and those in group A were higher than those in group B There was no correlation between cell growth rate and G-CSF level (r = 0.116, P = 0.518), and positive correlation with G-CSFr (r = 0.429, P <0.05). Conclusion: rhG-CSF has some effects on myelodysplastic syndrome, aplastic anemia and drug-induced neutropenia, but it has the best effect on drug-induced leukopenia and the worst aplastic anemia, which may be related to G- CSFr expression has a certain relationship.