重组人血小板生成素联合利妥昔单抗治疗免疫性血小板减少症疗效及对凝血功能和不良反应的影响

Efficacy of Recombinant Human Thrombopoietin Combined with Rituximab in the Treatment of Immune Thrombocytopenia and Its Influence on Coagulation Function and Adverse Reactions

目的:探究重组人血小板生成素(rhTPO)联合利妥昔单抗治疗免疫性血小板减少症(ITP)疗效及对凝血功能和不良反应的影响。方法:回顾性分析我院收治的198例ITP患者,根据治疗方案差异分组,根据患者一般资料进行倾向性评分匹配,最终获得一般资料均衡的对照组61例和研究组63例,对照组以利妥昔单抗治疗,观察组以rhTPO联合利妥昔单抗治疗,比较两组患者临床疗效、血小板计数(PLT)水平、凝血功能和不良反应情况。结果:研究组和对照组患者临床总有效率为68.85%和80.95%(P>0.05),但研究组患者完全反应率显著高于对照组(P<0.05),起效时间显著短于对照组(P<0.05);两组患者治疗1周、2周、4周、8周、12周的PLT水平较治疗前均提高(P<0.05),且研究组治疗2周、4周、8周、12周的PLT水平均高于对照组(P<0.05);治疗前后,两组患者部分活化凝血活酶时间(APTT)、凝血酶原时间(PT)及纤维蛋白原(FIB)水平变化,差异无统计学意义(P>0.05),组间比较,各指标水平差异也无统计学意义(P>0.05);治疗期间,对照组和观察组患者不良反应发生率(19.67%vs 25.40%)差异无统计学意义(P>0.05)。结论:rhTPO联合利妥昔单抗治疗ITP疗效显著,可在短时间内提高PLT水平,对患者凝血功能无不利影响,临床用药安全。

Objective:To explore the efficacy of recombinant human thrombopoietin(rhTPO)combined with rituximab in the treatment of immune thrombocytopenia(ITP)and its influence on coagulation function and adverse reactions.Methods:A total of 198 patients with ITP in our hospital were retrospectively analyzed,and they were grouped according to the treatment regimens.Propensity score matching was conducted according to the general data of patients,and finally 61 cases in control group and 63 cases in study group with balanced general data were obtained.Control group was treated with rituximab,and observation group was treated with rhTPO combined with rituximab.The clinical efficacy,platelet count(PLT),coagulation function and adverse reactions were compared between the two groups.Results:After treatment,the clinical total effective rate was 68.85%in study group and 80.95%in control group(P>0.05),but the complete response rate of patients in study group was significantly higher than that in control group(P<0.05),and the onset time was significantly shorter than that in control group(P<0.05).The PLT levels after 1 week,2 weeks,4 weeks,8 weeks and 12 weeks of treatment in the two groups were all higher than those before treatment(P<0.05),and the PLT levels in study group after 2 weeks,4 weeks,8 weeks and 12 weeks of treatment were higher than those in control group(P<0.05).Before and after treatment,there were no significant differences in the levels of activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB)between the two groups(P>0.05),and there were no statistically significant differences in the levels of indicators between the groups(P>0.05).During treatment,there was no significant difference in the incidence rate of adverse reactions between control group and observation group(19.67%vs 25.40%)(P>0.05).Conclusion:RhTPO combined with rituximab has a significant efficacy in the treatment of ITP.It can increase the level of PLT in a short period of time,and it does not adversely affect the coagulation function,with clinical safety of medication.