阿伐曲泊帕治疗慢性肝病相关性血小板减少症临床疗效分析

Clinical efficacy analysis of Avatrombopag in thrombocytopenia associated with chronic liver disease.

目的评估真实世界中应用阿伐曲泊帕治疗慢性肝病相关性血小板减少症的安全性及有效性。方法收集2021年3月至2023年10月在河南省人民医院拟行有创操作并接受阿伐曲泊帕治疗的慢性肝病相关性血小板减少症患者的资料(共300例),记录并分析血小板计数变化、输血情况及不良反应。结果慢性肝病相关性血小板减少症患者应用阿伐曲泊帕治疗的总体有效率为82.0%;治疗前血小板为(39.45±16.37)×10^(9)/L,中位起效时间为7(5,14)d,中位峰值时间为13(6,18)d,峰值血小板为(123.65±12.22)×10^(9)/L,血小板增幅为(83.79±27.5)×10^(9)/L;用药后9.0%的患者输注了血小板,未见不良事件;阿伐曲泊帕在基线血小板<30×10^(9)/L时疗效更显著(P<0.05);用药28 d时血小板计数仍高于基线值(P<0.0001)。结论真实世界中阿伐曲泊帕可显著提高慢性肝病相关性血小板减少症患者的血小板计数,减少血小板输注率,疗效持久,无严重不良反应。

Objective To assess the safety and effect of Avatrombopag in real world chronic hepatosis related thrombocytopenia patients.Methods The data of patients with thrombocytopenia related to chronic liver disease who planned to undergo invasive operation and received Avatrombopag treatment in Henan Provincial People's Hospital from March 2021 to October 2023 were collected,and the changes in platelet count,blood transfusion and adverse reactions were recorded and analyzed.Results The overall response rate of Avatrombopag for Chronic hepatosis related thrombocytopenia was 82.0%;The baseline platelet level was(39.45±16.37)×10^(9)/L,The median onset time was 7(5,14)d,The median peak time was 13(6,18)d,The peak platelet count was(123.65±12.22)×10^(9)/L,The platelet count increase was(83.79±27.5)×10^(9)/L;9.0%of the patients received platelet transfusion,None of the patients had serious adverse events;The Avatrombopag efficacy was more significant at baseline platelets<30×10^(9)/L(P<0.05);Platelet count remained above baseline at 28 days of administration(P<0.0001).Conclusion Avatrombopag can significantly improve the platelet count in Chronic hepatosis related thrombocytopenia patients and reduce the bleeding risk and platelet transfusion rate,without obvious serious adverse effects.