目的 评估聚乙二醇重组人粒细胞刺激因子（polyethylene glycolated recombinant human gran⁃ ulocyte stimulating factor，PEG⁃rhG⁃CSF）预防骨肉瘤患者初次吡柔比星联合顺铂方案化疗后引起的中性粒细胞绝对数（absolute neutrophil count，ANC）减少的临床效果。方法 纳入初诊为骨肉瘤的患者 77 例为研究对象。根据化疗后是否预防性应用 PEG⁃rhG⁃CSF 将其分为对照组（rhG⁃CSF 组）25 例、观察组（PEG⁃rhG⁃ CSF 联合 rhG⁃CSF 组）52 例。患者初次化疗方案均为 AP 案。通过定期观测血常规评估化疗后 ANC 减少 及预防性应用 PEG⁃rhG⁃CSF 的效果。结果 预防性应用 PEG⁃rhG⁃CSF 可以显著缩短 ANC 减少的持续时 间，降低Ⅲ⁃Ⅳ级 ANC 减少和粒细胞减少性发热（febrile neutropenia，FN）的发生率，减少补充使用rhG⁃CSF 的使用剂量和时间，同时减少了抗生素的使用时间（P < 0.05）。结论 预防性应用PEG⁃rhG⁃CSF 可以有效的降低吡柔比星联合顺铂方案化疗后 ANC 减少的发生，且安全性良好。有益于保证骨肉瘤患者后续大剂量、高强度化疗的顺利进行。

Objective To investigate the prevention efficiency of Pegylated recombinant human granulo⁃ cyte stimulating factor（PEG⁃rhG⁃CSF）on chemotherapy⁃naïve osteosarcoma patients treated by pirarubicin and cisplatin. Methods 77 chemotherapy ⁃naïve osteosarcoma patients were enrolled for the study. The patients were non ⁃ randomly divided into a control group（rh ⁃CSF group）with 25 patients and an experiment group（rhG ⁃CSF combined with PEG⁃rhG⁃CSF group）with 52 patients，according to whether they received PEG⁃rhG⁃CSF after AP chemotherapy. The prevention effect of PEG⁃rhG⁃CSF on reduction of neutrophils after chemotherapy were evaluat⁃ ed. Results Prophylaxis of PEG⁃rhG⁃CSF significantly reduced the incidence of Ⅲ⁃Ⅳ degree of ANC reduction， shorten the duration of ANC reduction，decreased the dosage and days of supplemental usage of rhG⁃CSF，reduced the incidence of FN and shorten the days of antibiotic usage（all P < 0.05）. Conclusion Prophylaxis of PEG⁃rhG⁃ CSF can effectively prevent the occurrence and duration of neutropenia with good safety. It is beneficial to ensure the following high⁃dose and high⁃intensity chemotherapy for osteosarcoma patients.