摘要
目的观察阿伐曲泊帕与重组人血小板生成素(recombinant human thrombopoietin,rhTPO)治疗肿瘤化疗所致血小板减少症(chemotherapy induced thrombocytopenia,CIT)前、后血小板计数(platelet,PLT)变化,探讨其疗效及安全性。方法CIT患者69例,其中给予阿伐曲泊帕(口服40mg/次,1次/d)治疗者23例为观察组,给予rhTPO(皮下注射15000u/次,1次/d)治疗者46例为对照组,2组均治疗至PLT≥100×10^(9)/L或较治疗前PLT增加≥50×10^(9)/L时停药。比较2组治疗前,治疗第3、5、7天时PLT及治疗前后PLT差值;比较2组化疗周期数及治疗期间PLT<50×10^(9)/L持续时间、恢复至PLT≥75×10^(9)/L时间、恢复至PLT≥100×10^(9)/L时间、血小板输注比率、不良反应发生情况。结果2组治疗前,治疗第3、5、7天PLT均依次增高(P<0.05)。观察组化疗周期数<5个比率(73.9%)、治疗第7天PLT[106.0(62.0,143.0)×10^(9)/L]及治疗前后PLT差值[83.0(52.0,261.0)×10^(9)/L]均高于对照组[43.5%、79.5(55.5,103.8)×10^(9)/L、62.0(42.0,89.0)×10^(9)/L](P<0.05),治疗前PLT、治疗第3天PLT、治疗第5天PLT、治疗期间PLT<50×10^(9)/L持续时间、恢复至PLT≥75×10^(9)/L时间、恢复至PLT≥100×10^(9)/L时间与对照组比较差异均无统计学意义(P>0.05)。观察组治疗期间血小板输注比率(26.1%)、出血发生率(13.0%)及输注≥2u血小板比率(8.7%)与对照组(23.9%、10.9%、10.9%)比较差异均无统计学意义(P>0.05)。结论阿伐曲泊帕与rhTPO均可有效提升PLT,减少出血风险,安全性好;与rhTPO相比,阿伐曲泊帕提升PLT效果更佳,且口服给药应用方便。
Objective To observe the changes of platelet(PLT)before and after treatment with avatrombopag or recombinant human thrombopoietin(rhTPO)in patients with chemotherapy induced thrombocytopenia(CIT),and to investigate the efficacy and safety.Methods In 69CIT patients,23received oral administration of avatrombopag(40mg,once a day)(observation group)and 46received subcutaneous injection of rhTPO(15000u,once a day)(control group),which were terminated till PLT≥100×10^(9)/L or PLT increased by≥50×10^(9)/L compared with before treatment.PLT counts before treatment and by day 3,5and 7after treatment,PLT difference before and after treatment,chemotherapy cycles,duration of PLT<50×10^(9)/L,time of recovery to PLT≥75×10^(9)/L,time of PLT≥100×10^(9)/L,percentage of patients receiving platelet transfusion and occurrence of adverse reactions were compared between two groups.Results PLT increased sequentially in two groups before treatment,and by day 3,5and 7of treatment(P<0.05).The percentage of patients receiving chemotherapy cycles<5cycles,PLT by day 7and PLT difference before and after treatment were higher in observation group[73.9%,106.0(62.0,143.0)×10^(9)/L,83.0(52.0,261.0)×10^(9)/L]than those in control group[43.5%,79.5(55.5,103.8)×10^(9)/L,62.0(42.0,89.0)×10^(9)/L](P<0.05),and there were no significant differences in the PLT counts before treatment and by day 3and 5of treatment,duration of PLT<50×10^(9)/L,time of recovery to PLT≥75×10^(9)/L,and time of PLT≥100×10^(9)/L between two groups(P>0.05).The percentage of patients receiving PLT transfusion,incidence of bleeding and percentage of patients receiving≥2uPLT transfusion showed no significant differences between observation group(26.1%,13.0%,8.7%)and control group(23.9%,10.9%,10.9%)(P>0.05).Conclusions Both avatrombopag and rhTPO can effectively elevate PLT count,reduce the risk of bleeding,and have a high safety.Avatrombopag is superior to rhTPO,and oral administration is much easier and more convenient.
作者
徐慧
赵洋
马雅婷
陈研仿
张明智
李玲
XU Hui;ZHAO Yang;MA Ya-ting;CHEN Yan-fang;ZHANG Ming-zhi;LI Ling(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《中华实用诊断与治疗杂志》
2022年第10期1073-1076,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金面上项目(81970184)
河南省医学科技攻关计划联合共建项目(LHGJ20190008)。
