促红细胞生成素治疗肿瘤化疗导致血小板减少症的临床研究

Clinical observation of erythropoietin on thrombocytopenia of malignancies after chemotherapy

目的:观察促红细胞生成素(EPO)治疗肿瘤化疗后血小板减少症的有效性和安全性。方法:给予国产rhEPO10000U,皮下注射,每天1次,连续5天;若未见效,最多可延长至10天;如治疗过程中血小板数≥100×109/L,即可停药。结果:治疗患者51例,血小板数有13例在5天内升高至100×109/L或提高了20×109/L,19例在10天内升高至100×109/L或提高了20×109/L,总有效率达62.8%;血小板平均数由治疗前(60.35±10.17)×109/L上升至治疗后(84.87±15.85)×109/L,差异非常显著(P<0.001)。结论:EPO能有效地治疗肿瘤化疗后血小板减少,而且升血小板快,特别是对血小板轻、中度降低的患者,有显著疗效,价格较rhTPO亦相对便宜;不良反应轻微,主要为局部注射部位疼痛、红肿及硬结,值得在临床上推广应用。

Objective： To observe the efficacy and safety of erythropoietin （EPO） in the treatment of thrombopenia induced by chemotherapy. Methods：10 000U of Chinese recombined humanized EPO （rhEPO） was injected hypodermically to patients after chemotherapy per day for 5 days and could prolong to 10 days to those uneffecient patients, rhEPO was discontinued when thrombocyte counts were rounded up to 100 × 10^9/L. Results：There were 51 cases with malignancies treated by chemotherapy enrolled in our study. In which, there were 13 cases whose thrombocyte counts reached to 100 × 10^9/L or increased more than 20 × 10^9/L in 5 days and 19 cases in 10 days. The overall response rate was 62. 8%. The mean counts of thrombocyte before and after treatment were （60. 35 ± 10. 17 ） × 10^9/L and （ 84. 87±15.85 ） × 10^9/L （ P 〈0. 001 ） ,respectively. Conclusion：Patients with thrombopenia induced by chemotherapy could be effectively and swiftly treated by rhEPO, especially to those decreased mildly and moderately. The price of rhEPO is cheap compared with rhTPO and the adverse effects are mild, mainly included pain, edema, and induration at injection site. Clinical administration is worthy of generalization.