TPO-RA联合rhTPO和TPO受体激动剂单药治疗放化疗所致血小板减少的疗效及安全性研究

目的TPO受体激动剂(TPO-RA)联合重组人血小板生成素(Recombidnant human thrombopoietin,rhTPO)和TPO-RA(Thrombopoietin receptor agonist)单药治疗放化疗所致血小板减少的血小板应答情况,探讨其疗效及安全性。方法回顾性分析2022年1月—2023年1月期间许昌市中心医院肿瘤诊疗中心诊断化放疗后血小板减少的患者,联合用药组及单药组分别25例,比较两组早期应答率、早期高应答比率及完全应答时间、药物不良反应发生情况。观察时间至血小板完全应答时终止。结果联合组早期应答率低于单药组、早期应答程度高于单药组,完全应答时间均值长于单药组,联合用药组中患者3周未完全应答比例占12%,单药组中3周内均完全应答,但以上差异较单药组并无显著统计学意义。联合组出血、血栓、消化道反应、头晕头痛、疲劳乏力发生率均高于单药组,其中血栓发生率16%,相较于单药组4%升高差异有统计学意义,头晕头痛发生率84%,相较于单药组24%升高差异有统计学意义,其它不良反应差异均无统计学意义。结论较TPO-RA类药物单药应用,TPO-RA类药物与rhTPO药物联用未增加升血小板治疗的疗效,同时可能增加血栓、头晕头痛等不良反应的风险,增加患者经济方面负担。

Effectiveness of total therapy in immune thrombocytopenia purpura:case series

Immune Thrombocytopenic purpura(ITP)is a haematologicimmune-mediated disorder in which the amount of platelet in the blood decreases abnormally.Single-agent therapies for ITP have not proven successful in achieving long-term remission,with relapse occurring in about half of the patients(p/t).Treatment options which include Rituximab with Dexamethasone as frontline therapy,have durable response rates ranging from 58%to 76%.In this study,we have used‘Total therapy’as treatment which includes low-dose Rituximab in combination with Thrombopoietin receptor agonist(TPO-RA)(Romiplostim)and high-dose Dexamethasone.In this case series study,each patient received romiplostim(250 mcg weekly s/c,4 doses)in combination with low-dose rituximab(100 mg weekly IV,4 doses)and high-dose dexamethasone(40 mgIV on days 1-4and days 15-18).This treatment combination demonstrated rapid response rates and a low rate of side effects,making it a good alternative for individuals with ITP.

TPO抗体升高类风湿性关节炎患者的中医辨证分型

目的:探讨TPO抗体升高类风湿性关节炎患者中医证型分布及甲状腺功能情况。方法:结合相关文献制定病例报告表,并记录中医证候,运用聚类分析统计学方法对40例TPO抗体升高类风湿性关节炎患者的中医证候进行辨证分型。结果:TPO抗体升高类风湿性关节炎患者基本证候为:寒湿阻络证,湿热痹阻证,气血两虚证和肝肾阴虚证;甲状腺功能异常的比例为50.0%;中医证候符合肝郁气滞证的比例为32.5%。结论:TPO抗体升高类风湿性关节炎患者中医辨证分型初步分为:寒湿阻络证,湿热痹阻证,气血两虚证和肝肾阴虚证。中医证候符合肝郁气滞证的比例较高。