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目的探讨重组人粒细胞刺激因子(recombinant human-granulocyte colony sti mulating factor,rhG-CSF)和重组人血小板生成素(recombinant human-thrombopoietin,rhTPO)促进异基因造血干细胞移植后造血功能重建的作用。方法选取15例异基因造血干细胞移植患者,其中同胞间全相合移植6例,非血缘全相合移植7例,半相合移植2例,于移植后+1d予以rhG-CSF(300μg/d)和rhTPO(15 000u/d)治疗,观察患者造血重建的时间和相关并发症发生情况。结果患者于移植+15d(+8~+20d)N>0.5×109/L,移植+19d(+11~+23d)PLT>30×109/L,提示造血功能重建。移植+30d复查短串联重复序列(STR)检测,均提示重建造血为供者造血。随访至今,所有患者造血稳定重建。15例患者中10例出现感染、发热;15例患者均出现不同程度的皮下出血,多表现为皮肤淤点淤斑,2例患者出现鼻出血;3例患者在造血重建前夕出现全身骨痛。3例出现Ⅱ度以下急性移植物抗宿主病(GVHD),2例患者出现轻度的慢性GVHD。结论rhG-CSF联合rhTPO促进异基因造血干细胞移植后造血重建疗效肯定,减少移植感染、出血等并发症的发生率,缩短层流病房住院日,减少血小板、红细胞等血液制品的输入量,降低移植费用。
Objective To investigate the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and recombinant human thrombopoietin (rhTPO) on hematopoietic reconstitution after allogeneic hematopoietic stem cell transplantation. Methods Fifteen patients with allogeneic hematopoietic stem cell transplantation were enrolled in this study. Among them, 6 were allografted with sibs, 7 were non-blood-matched allografts and 2 were combined with semi-matched transplantation. The rhG-CSF (300μg / d) and rhTPO (15 000u / d) treatment, observation of patients with hematopoietic reconstructive time and related complications. Results The patients had N> 0.5 × 109 / L on + 15d (+ 8 ~ + 20d) and PLT> 30 × 109 / L on + 19d (+ 11 ~ + 23d), suggesting hematopoietic reconstitution. Transplantation +30 d review short tandem repeat (STR) test, all prompted reconstruction of hematopoietic donor hematopoietic. All patients have stable hematopoietic reconstructions until now. In 15 cases, 10 cases had infection and fever. Fifteen patients showed different degree of subcutaneous hemorrhage, which manifested as ecchymosis and epistaxis in two patients and systemic pain in three patients on the eve of hematopoietic reconstitution. Three patients developed grade Ⅱ GVHD and two had mild chronic GVHD. Conclusion rhG-CSF combined with rhTPO can promote the hematopoietic reconstitution after allogeneic hematopoietic stem cell transplantation, reduce the incidence of complications such as transplanted infection and bleeding, shorten the hospitalization days of laminar flow ward, reduce the input of blood products such as platelet and erythrocyte, cost.