摘要
目的:评价重组人血小板生成素(rhTPO)治疗成人血液肿瘤化疗后血小板减少的有效性与安全性。方法:采用循证医学的方法,计算机检索CBM、CNKI、MEDLINE、EMBASE、Cochrane图书馆临床对照试验资料库等数据库,收集rhTPO治疗成人血液肿瘤化疗后血小板减少的临床研究证据。结果:共纳入7篇文献。与对照组相比,rhTPO试验组血小板计数最低值、血小板计数恢复的最高值、血小板<50×109·L-1的持续天数、血小板恢复≥100×109·L-1的天数以及血小板输注量加权均数差值(WMD)(95%可信区间(CI))分别为1.06(-0.08,2.20)、67.19(32.1,101.58)、-3.35(-4.51,-2.18)、-2.97(-4.63,-1.32)、-2.58(-4.92,-0.24),不良反应发生率相对危险度(RR)(95%CI)为4.69(1.90,11.58)。结论:现有研究显示,在治疗成人血液肿瘤化疗后血小板减少方面,rhTPO能够提高血小板恢复的最高值和增加值,缩短化疗后血小板<50×109·L-1的持续天数,加快血小板的恢复速度,并间接减少血小板输注量,且不良反应轻微。然而,目前临床试验设计存在不足,尚需进行设计良好的大样本研究验证。
OBJECTIVE： To evaluate the efficacy and safety of recombinant human thromobopoietin （rhTPO） in the treatment of hematology malignance chemotherapy induced thrombocytopenia （RITP）. METHODS： Literature analysis based on evidence-based medicine was performed. The databases of controlled clinical trials including CBM, CNKI, MEDLINE, EMBASE and Cochrane Library were retrieved to collect clinical research documents on the efficacy of rhTPO in the treatment of RITP. RESULTS： 7 studies were included. Meta-analysis showed： compared with control group, WMD （95%CI）in rhTPO group of minimum platelet count, maximum platelet count recovery, duration of platelet count〈50×10^9·L^-1, duration of platelet recovery≥100×10^9·L^-1 and platelet transfusion amount were 1.06 （-0.08,2.20）,67.19（32.1, 101.58）,-3.35（-4.51,-2.18）,-2.97（-4.63,-1.32）,-2.58 （-4.92,-0.24）, respectively. The incidence of adverse drug reactions RR （95%CI） was 4.69 （1.90, 11.58）. CONCLUSION： For the treatment of hematology malignance chemotherapy induced thrombocytopenia, study has demonstrated that rhTPO can improve maximum and minimum platelet count recovery, shorten the duration of platelet count〈50×10^9·L^-1, speed up platelet recovery and indirectly reduce platelet transfusion amount with slight ADR. However, there is limitation in clinical research design, and well-designed larger-scale sample study is necessary.
出处
《中国药房》
CAS
CSCD
北大核心
2011年第42期3987-3990,共4页
China Pharmacy
关键词
重组人血小板生成素
血液肿瘤化疗
血小板减少
有效性
安全性
Recombinant human thromobopoietin
Hematology malignance chemotherapy
Thrombocytopenia
Efficacy
Safety
