重组人血小板生成素对化疗相关性血小板减少症的预防作用

Preventive effect of different doses of recombinant human thrombopoietin on chemotherapy-induced thrombocytopenia

目的探讨不同剂量重组人血小板生成素(rhTPO)对化疗相关性血小板减少症的预防作用。方法回顾性分析进行rhTPO二级预防的患者57例,分为A组和B组2组。A组化疗结束后24~48 h开始,给予单日rhTPO剂量为15000 u,每天1次或隔天1次,以化疗后rhTPO治疗期间血小板计数恢复至100×109个/L为停药标准;B组rhTPO用药剂量为7500 u,方法同A组。比较观察2组预防效果。结果A组和B组患者预防周期化疗后血小板计数下降值分别为(25.52±18.50)×109个/L、(38.41±27.63)×109个/L,差异有统计学意义(t=2.013,P=0.040)。A组和B组患者预防周期化疗后血小板计数下降值均低于前一周期的(40.46±29.55)×109个/L、(44.79±30.81)×109个/L,其中A组比较差异有统计学意义(t=2.607,P=0.011),而B组比较差异无统计学意义(t=0.689,P=0.495)。A组和B组患者下一周期化疗开始前血小板计数回升至正常值的患者比例分别为75.68%(28/37)、55.00%(11/20),差异无统计学意义(χ^2=2.569,P=0.109)。2组患者不良反应发生情况比较差异均无统计学意义(P<0.05)。结论高剂量rhTPO对化疗相关血小板减少症二级预防作用更好,且不增加不良反应,安全性良好。

Objective To explore the preventive effect of different doses of recombinant human thrombopoietin(rhTPO)on chemotherapy-induced thrombocytopenia.Methods The 57 patients with secondary prevention of rhTPO were divided into two groups:the group A and the group B.the dose of the group A was 15000 u once a day,once a day or once every other day from 24-48 hours after chemotherapy,and the platelet count recovered to 100×109/L during the treatment of rhTPO after chemotherapy as the stop standard;the dosage of rhTPO in the group B was 7500 u,the same method as that in the group A.The preventive effect of thrombocytopenia in the two groups were compared.Results The decrease of platelet in the group A and the group B were(25.52±18.50)×109/L and(38.41±27.63)×109/L,which was statistically significant(t=2.013,P=0.040).Compared with the previous chemotherapy cycle[(40.46±29.55)×109/L and(44.79±30.81)×109/L],the decrease of platelet in the group A was significantly smaller,and the difference was statistically significant(t=2.607,P=0.011);but the difference in the group B was not statistically significant(t=0.689,P=0.495).The proportions of patients with platelet normal value were 75.68%(28/37)and 55.00%(11/20)in the group A and the group B,respectively(χ^2=2.569,P=0.109).There were no statistically significant difference between the two groups(P<0.05).Conclusion High dose rhTPO is more effective in the secondary prevention of chemotherapy-induced thrombocytopenia,and has the good safety.