摘要
目的观察重组人血小板生成素(rhTPO)治疗脓毒症相关血小板减少症的疗效。方法将收治的脓毒症合并血小板减少症的患者分成实验组(34例)和对照组(42例)。实验组皮下注射rhTPO 15 000 U/d,当血小板计数(PLT)> 100×109/L时停用。监测所有患者治疗前及治疗后1、3、5、7 d PLT;监测凝血、肝、肾功能,ICU住院时间、机械通气时间及28 d病死率,出血、血制品输注情况及药物不良反应。结果经治疗后实验组与对照组相比PLT升高(F=6. 301,P <0. 05),且实验组PLT在第5、7天较对照组明显升高[(79. 5±40. 64)×109/L与(56. 04±25. 08)×109/L,t=2. 179,P <0. 05;(107. 36±17. 35)×109/L与(72. 57±22. 78)×109/L,t=2. 360,P <0. 05]。实验组经治疗7 d后凝血指标部分凝血酶原时间(APTT)、纤维蛋白原(FIB)较治疗前改善[(56. 34±18. 24) s与(42. 81±13. 40) s,t=2. 20,P <0. 05;(3. 76±1. 50) g/L与(2. 70±1. 21) g/L,t=2. 479,P <0. 05]; 2组治疗7 d后肝、肾、凝血功能,ICU住院时间、机械通气时间及28 d病死率比较差异无统计学意义。无药物不良反应。结论 rhTPO可升高脓毒症相关血小板减少症患者的血小板含量,减少血制品的输注,对凝血功能有所改善,临床应用安全有效。
Objective To observe the curative effect of recombinant human thrombopoietin（rhTPO） in patients with sepsis-associated thrombocytopenia. Methods The patients with sepsis associated thrombocytopenia from were divided into experimental group（n = 34） and control group（n = 42）. The patients in the experimental group received rhTPO 15000 U for one day by hypodermic injection,and withdrew when the absolute value of the platelet count increases 100 × 109/L,and the course was 7 days. The platelet count,blood coagulation,liver and kidney function,ICU hospital stay,mechanical ventilation time and 28 day mortality,bleeding,blood transfusion and adverse drug reactions were detected before and after the treatment of 1,3,5 and 7 days. Results After treatment,the platelet count was increased in experimental group comparing with those in the control group（P 0. 05）; Particularly,the platelet count in the experimental group was significantly higher than that in the control group in day 5 and 7 [（79. 5 ± 40. 64） × 109/L vs.（56. 04 ±25. 08） × 109/L,P 0. 05;（107. 36 ± 17. 35） × 109/L vs.（72. 57 ± 22. 78） × 109/L,P 0. 05]. 7 days after treatment,Partial Prothrombin Time（APTT） and Fibrinogen（FIB） of the experimental group were improved [（56. 34 ± 18. 24） s vs.（42. 81 ± 13. 40） s,P 0. 05;（3. 76 ± 1. 50） g/L vs.（2. 70 ± 1. 21） g/L,P 0. 05]; Liver function,renal function and blood coagulation all show no statistical significance differences between the two groups after 7 days of treatment. ICU hospitalization time,mechanical ventilation time and 28 day mortality all show no statistical significance differences between the two groups. No adverse drug reactions occurred in both groups. Conclusion The use of rhTPO in patients with sepsis associated thrombocytopenia is safe and effective,it can increase the platelet count,decrease the amount of blood product transfusion,and improve coagulation function.
作者
张小亚
祁文娟
周文杰
刘勤富
王晓红
杨晓军
ZHANG Xiaoya;QI Wenjuan;ZHOU Wenjie;LIU Qinfu;WANG Xiaohong;YANG Xiaojun(Department of Critical Care Medicine,Gen-eral Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《宁夏医学杂志》
CAS
2018年第9期784-787,共4页
Ningxia Medical Journal
基金
十三五国家重点计划项目(2016YFO0400605)
