目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimu...目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rhG-CSF)在预防恶性肿瘤化疗相关中性粒细胞减少症中的疗效与安全性差异,为临床合理用药提供循证医学依据。方法本研究采用系统性文献检索策略,全面检索Embase、Web of Science、PubMed、the Cochrane Library、中国知网、万方和维普数据库,收集从建库至2024年8月17日发表的关于PEG-rhG-CSF与rhG-CSF预防恶性肿瘤化疗相关中性粒细胞减少症的随机对照试验。由2名研究者独立进行文献筛选、数据提取及方法学质量评价,采用Cochrane偏倚风险评估工具对纳入研究进行质量评估。使用RevMan 5.4软件进行Meta分析,二分类变量采用风险比及其95%CI表示效应量,连续性变量采用均数差(MD)及其95%CI表示。研究间异质性采用I²统计量进行评估,I²>50%时采用随机效应模型,否则采用固定效应模型。结果共纳入28项随机对照临床试验,涉及2879例恶性肿瘤患者。根据Meta分析结果表明,PEG-rhG-CSF组在减少Ⅲ/Ⅳ度中性粒细胞减少持续时间方面优于rhG-CSF组(P<0.05)。不良反应事件发生率与rhG-CSF组差异没有统计学意义(P>0.05)。结论与rhG-CSF相比,PEG-rhG-CSF可显著缩短恶性肿瘤患者化疗后重度(Ⅲ/Ⅳ度)中性粒细胞减少的持续时间。基于现有循证医学证据,建议在恶性肿瘤化疗患者中优先选用PEG-rhG-CSF进行中性粒细胞减少症的预防,以降低感染风险,保障化疗周期顺利进行并改善患者预后。展开更多
Background:In patients receiving anticancer chemotherapy,polyethylene glycolated recombinant human granulocyte-colony stimulating factor(PEG-rhG-CSF)was used for prophylaxis of chemotherapy-induced neutropenia.However...Background:In patients receiving anticancer chemotherapy,polyethylene glycolated recombinant human granulocyte-colony stimulating factor(PEG-rhG-CSF)was used for prophylaxis of chemotherapy-induced neutropenia.However,the side effect of PEG-rhG-CSF use on fasting blood glucose(FBG)level remains unclear.Materials and Methods:Cancer patients receiving chemotherapy and PEG-rhG-CSF were enrolled in our study.Baseline glucose(Glucose 1)was measured before PEG-rhG-CSF use,a second FBG test(Glucose 2)was performed after PEG-rhG-CSF use.Mean glucose levels were compared using t test.Results:The time interval between PEG-rhG-CSF use and the second glucose test was 2.4±1.5 days.The mean Glucose 1 was 5.18±0.53 mmol/L,and Glucose 2 was 3.80±1.13 mmol/L.Statistical analysis showed a significant difference between Glucose 1 and 2 existed(P<0.001).Conclusion:Our study identifies a hypoglycemic side effect of PEG-rhG-CSF occurs in cancer patients undergoing anti-cancer chemotherapy.Our results highlight the caution required when using PEG-rhG-CSF for prophylaxis of chemotherapyinduced neutropenia.展开更多
文摘目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rhG-CSF)在预防恶性肿瘤化疗相关中性粒细胞减少症中的疗效与安全性差异,为临床合理用药提供循证医学依据。方法本研究采用系统性文献检索策略,全面检索Embase、Web of Science、PubMed、the Cochrane Library、中国知网、万方和维普数据库,收集从建库至2024年8月17日发表的关于PEG-rhG-CSF与rhG-CSF预防恶性肿瘤化疗相关中性粒细胞减少症的随机对照试验。由2名研究者独立进行文献筛选、数据提取及方法学质量评价,采用Cochrane偏倚风险评估工具对纳入研究进行质量评估。使用RevMan 5.4软件进行Meta分析,二分类变量采用风险比及其95%CI表示效应量,连续性变量采用均数差(MD)及其95%CI表示。研究间异质性采用I²统计量进行评估,I²>50%时采用随机效应模型,否则采用固定效应模型。结果共纳入28项随机对照临床试验,涉及2879例恶性肿瘤患者。根据Meta分析结果表明,PEG-rhG-CSF组在减少Ⅲ/Ⅳ度中性粒细胞减少持续时间方面优于rhG-CSF组(P<0.05)。不良反应事件发生率与rhG-CSF组差异没有统计学意义(P>0.05)。结论与rhG-CSF相比,PEG-rhG-CSF可显著缩短恶性肿瘤患者化疗后重度(Ⅲ/Ⅳ度)中性粒细胞减少的持续时间。基于现有循证医学证据,建议在恶性肿瘤化疗患者中优先选用PEG-rhG-CSF进行中性粒细胞减少症的预防,以降低感染风险,保障化疗周期顺利进行并改善患者预后。
文摘Background:In patients receiving anticancer chemotherapy,polyethylene glycolated recombinant human granulocyte-colony stimulating factor(PEG-rhG-CSF)was used for prophylaxis of chemotherapy-induced neutropenia.However,the side effect of PEG-rhG-CSF use on fasting blood glucose(FBG)level remains unclear.Materials and Methods:Cancer patients receiving chemotherapy and PEG-rhG-CSF were enrolled in our study.Baseline glucose(Glucose 1)was measured before PEG-rhG-CSF use,a second FBG test(Glucose 2)was performed after PEG-rhG-CSF use.Mean glucose levels were compared using t test.Results:The time interval between PEG-rhG-CSF use and the second glucose test was 2.4±1.5 days.The mean Glucose 1 was 5.18±0.53 mmol/L,and Glucose 2 was 3.80±1.13 mmol/L.Statistical analysis showed a significant difference between Glucose 1 and 2 existed(P<0.001).Conclusion:Our study identifies a hypoglycemic side effect of PEG-rhG-CSF occurs in cancer patients undergoing anti-cancer chemotherapy.Our results highlight the caution required when using PEG-rhG-CSF for prophylaxis of chemotherapyinduced neutropenia.
