重组人促红素治疗1例肿瘤相关性贫血分析

陈元娜+叶晓芬+顾宇彤+蔡映云+吕迁洲

摘 要 1例原发性支气管肺癌患者，入院行第4次化疗。入院后血常规提示存在中度贫血，基于前3次化疗后血红蛋白持续下降的情况，医生认为该患者目前不宜化疗。为确定贫血的治疗方案，医生咨询了临床药师，药师查阅文献后建议选用重组人促红素（recombinant human erythropoietin，rhEPO）治疗贫血，待血红蛋白升到80 g/L后，再开始化疗。患者在rhEPO联合铁剂治疗一周后，血红蛋白值升至81 g/L，顺利完成化疗，病情平稳出院。

关键词 肿瘤相关性贫血 重组人促红素 临床药师

中图分类号：R973.5 文献标识码：C 文章编号：1006-1533（2016）19-0072-04

Analysis of recombinant human erythropoietin in the treatment of one case of cancer-related anemia

CHEN Yuanna1*， YE Xiaofen2**， GU Yutong3， CAI Yingyun2， LV Qianzhou2（1. Clinical Pharmacist Training Base of Health and Family Planning Commission， Zhongshan Hospital，

Fudan University； 2. Department of Pharmacy， Zhongshan Hospital， Fudan University； 3. Department of respiration， Zhongshan Hospital， Fudan University， Shanghai 200032， China）

ABSTRACT A patient with primary bronchogenic carcinoma was admitted to our hospital for the fourth chemotherapy. His blood regular test showed that he got moderate anemia. Based on the situation that his hemoglobin level continues to decline after the first three doses of chemotherapy， doctors believed that he might be not suitable for further chemotherapy currently. However， the doctor changed his idea after consulting the clinical pharmacist about establishing an appropriate treatment for anemia. The pharmacist， after a review of the literature， recommended doctors that the recombinant human erythropoietin （rhEPO） would be used and the chemotherapy could be started when his hemoglobin level rose to 80 g/L. The hemoglobin level of this patient increased to 81g/L after he was treated with rhEPO and iron for one week. Finally， the chemotherapy was finished and the patient had a stable condition and was discharged from our hospital.

KEY WORDS cancer-related anemia； recombinant human erythropoietin； clinical pharmacist

贫血是指外周血中单位容积内红细胞数（RBCs）减少或血红蛋白（Hb）浓度减低，致使机体不能对周围组织细胞充分供氧的一种疾病。肿瘤相关性贫血（cancerrelated anemia，CRA）主要是指肿瘤患者在其疾病的发展及治疗过程中发生的贫血。贫血可引起组织缺氧，不仅使患者生活质量降低，还使肿瘤组织对放疗、化疗敏感性降低，且贫血程度与化疗疗效、化疗药物的敏感性及耐药性密切相关，贫血患者常规化疗预后较差。促红细胞生成素（EPO）是治疗肿瘤相关性贫血的主要药物，可有效提高患者的血红蛋白水平，提高放疗、化疗的疗效，改善肿瘤患者的生活质量[1]。由于接受EPO治疗的肿瘤患者常存在铁缺乏的现象，影响EPO的疗效，所以对这些患者还需考虑补铁治疗。本文就1例EPO治疗肿瘤相关性贫血的病例进行分析讨论。

1 病史摘要

患者，男性，57岁。身高1.7 m，体重66 kg，体表面积1.77 m2。因“确诊右肺腺癌2月余”于2016年1月18日入院。……