【摘要】：目的·研究神經(jīng)母細胞瘤高危組患兒化學(xué)治療(化療)后外周血中性粒細胞和淋巴細胞的水平、嚴重感染率及與化療組合的關(guān)系,為高危組患兒化療后預(yù)防感染提供指導(dǎo)。方法·分析自2012年7月至2015年9月在上海交通大學(xué)醫(yī)學(xué)院附屬新華醫(yī)院首診住院的神經(jīng)母細胞瘤高危組患兒45例,記錄化療方案及化療后反應(yīng),記錄化療第1、第5、第10、第15及第20日的中性粒細胞及淋巴細胞絕對值,隨訪并記錄化療后的感染情況,進行統(tǒng)計學(xué)分析。結(jié)果·化療后中性粒細胞及淋巴細胞在每輪化療第10日左右降至最低,第15日左右上升。感染發(fā)生與第10日的中性粒細胞(r=-0.245)及淋巴細胞(r=-0.227)數(shù)量呈負相關(guān)。淋巴細胞在4輪化療后進入持續(xù)性淋巴細胞缺乏期。神經(jīng)母細胞瘤高危組化療后Ⅳ級骨髓抑制達90.0%,嚴重感染率達15.5%,3個化療藥物組合之間在Ⅲ級(P=0.008)和Ⅳ級骨髓抑制(P=0.001)及嚴重感染發(fā)生方面(P=0.010)差異統(tǒng)計學(xué)意義。結(jié)論·神經(jīng)母細胞瘤高危組兒童化療后有明顯的骨髓抑制和較高的感染發(fā)生率,尤其是環(huán)磷酰胺+阿霉素+長春新堿組合,需重視此組兒童化療的耐受度,積極采取措施以降低嚴重感染率。
[Abstract]:Objective to study the level of neutrophils and lymphocytes in peripheral blood of children with high risk neuroblastoma after chemotherapy (chemotherapy), the serious infection rate and the relationship with chemotherapy combination, so as to provide guidance for the prevention of infection after chemotherapy in high risk group. Methods from July 2012 to September 2015, 45 children with high risk neuroblastomas were admitted to Xinhua Hospital affiliated to Medical College of Shanghai Jiaotong University. The chemotherapy regimen and post-chemotherapy reaction were recorded. The absolute values of neutrophils and lymphocytes on the 1st, 5th, 10th, 15th and 20th day of chemotherapy were recorded. The infection after chemotherapy was followed up and recorded. Results after chemotherapy, neutrophils and lymphocytes decreased to the lowest on the 10th day of each round of chemotherapy and increased around the 15th day. The incidence of infection was negatively correlated with the number of neutrophils (r 鈮，

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