咖啡酸片治疗肿瘤化疗所致血小板减少症的临床观察

Clinical observation of caffeic acid in the treatment of thrombocytopenia (CIT) caused by cancer chemotherapy

目的:观察咖啡酸片治疗肿瘤化疗所致血小板减少症(chemotherapy induced thrombocytopenia,CIT)的临床疗效及安全性。方法:采用自身对照的方法,选取上海交通大学医学院附属瑞金医院等11家三级甲等医院2016年1月22日至2017年1月10日收治的60例肿瘤化疗所致CIT患者。给予咖啡酸片/模拟剂治疗,均为3片/次,3次/d。第1个化疗周期(阴性对照期)于化疗开始第1 d给予咖啡酸片模拟剂;第2、3个化疗周期(药物治疗期)需要接受与第1个化疗周期相同方案及剂量的化疗,分别于化疗开始第1 d给予咖啡酸片。结果:药物治疗期最低血小板(platelet,PLT)的升高值显著高于阴性对照期(P<0.001);药物治疗期化疗后,PLT恢复后最高值显著高于阴性对照期(P<0.001);药物治疗期PLT<50×10~9/L的持续天数与阴性对照期无显著性差异,但有缩短趋势(P>0.05);药物治疗期化疗后PLT恢复至≥75×10~9/L和≥100×10~9/L,所需的天数较阴性对照期均明显减少(P<0.001);试验期间无患者行PLT输注。结论:咖啡酸片用于肿瘤化疗所致CIT患者,疗效确切,不良反应较少,具有广泛的临床应用前景。

Objective： To evaluate the clinical efficacy and safety of caffeic acid for thrombocytopenia induced by cancer chemotherapy. Methods： A total of 60 patients received the same chemotherapy treatment on cycles 1, 2, and 3. They were given mimetic agent as negative control on the first course. On the second and third cycles, caffeic acid tablets were given from the first day of chemotherapy. Results： The lowest and highest platelet levels of the treatment group during the drug treatment period were significantly higher than those of the negative control group（P0.001）. No significant difference in the period of days of PLT50×10~9/L was observed between the groups, although a decreasing trend（P0.05） was observed. After chemotherapy, the days required for platelet recovery to PLT≥75×10~9/L and PLT≥100×10~9/L in the treatment group was significantly fewer than in the negative control group（P0.001）. All the patients did not receive any platelet transfusion during the trial. Conclusion： Caffeic acid tablets were safe and effective for thrombocytopenia induced by tumor chemotherapy.