摘要
目的:观察重组人血小板生成素(rhTPO,特比澳)治疗化疗所致血小板(PLT)减少的疗效和不良反应。方法:采用病例自身对照研究,对第1个周期化疗(对照组)后PLT≤70×109/L的51例实体瘤患者,第2个周期(治疗组)采用相同方案化疗,化疗结束后24h开始,皮下注射特比澳15000U,每天1次,连续7天;若未见效,最多可延长至l4天;如治疗过程中血小板数≥100×109/L或血小板绝对数升高50×109/L,即可停药。结果:治疗组化疗后各时点PLT计数均高于对照组。(1)化疗后,治疗组和对照组PLT最低值分别为为(79.6±32.5)×109/L和(35.3±22.8)×109/L(P<0.001),血小板计数恢复后的最高值分别为(258.7±124.5)×109/L和(139.8±75.4)×109/L(P<0.001);(2)化疗后血小板<50×109/L的持续时间分别为(2.83±2.30)d和(5.58±5.30)d(t=1.715,P>0.05);(3)治疗组化疗后血小板恢复至75×109/L和100×109/L以上所需天数为(10.66±4.55)d和(13.00±4.22)d,而对照组为(19.33±8.72)d和(23.41±8.30)d(P<0.001);(4)2例患者在对照组化疗后需要输注血小板,而治疗组无1例需要输注血小板;(5)化疗后血红蛋白、白细胞、肝肾功能、凝血功能、胸片和心电图的变化无明显差异。不良反应轻,仅个别患者出现发热、头晕或寒战。结论:实体肿瘤患者化疗后出现血小板减少时,预防性给予rhTPO可减少血小板降低程度和持续时间,并能促进血小板及早恢复,且无严重不良反应,值得推广应用。
Objective：To observe the efficacy and safety of recombinant human thrombopoietin （rhTPO） in the treatment of thrombocytopenia induced by chemotherapy. Methods：A total of 51 solid tumor patients who developed thrombocytopenia induced by chemotherapy （PLT ≤70 ×10^9 /L） after the first cycle of chemotherapy （control group） was studied by self-cross contro1.24h after the second cycle of chemotherapy （treatment group） with identical scheme of the first cycle chemotherapy, they were given subcutaneous injection of rhTPO 15 000U/d for 7 to 14 consecutive days or until platelet count ≥ 100×10^9/L or the increasing count ≥50 ×10^9/L. Results：The mean platelet count of the patients after rhTPO treatment was higher at different time point of the treatment group than that of the control group. The minimal PLT count of the treatment group and the control group after chemotherapy were （79.6±32.5） 109/L and （35.3±22.8） 109/L （P〈0.001） respectively, and the maximal PLT count after its recovery were （258.7±124.5）×10^9/L and （139.8±75.4）×10^9/L （P〈0.001） respectively. The duration of PLT count〈50×10^9/L after chemotherapy in the treatment group and the control group was （2.83±2.30）d and （5.58±5.30）d （t=1.715,P〉0.05）. The time of PLT count recovering more than 75×10^9/L and 100×10^9/L in treatment group after chemotherapy was （10.66±4.55）d and （13.00±4.22） d（P〈0.001）, compared to （19.33±8.72） d and （23.41±8.30） d in control group （P〈0.001）. Two patients in control group needed PLT transfusion while no patients needed in treatment group. The changes of hemoglobin content, white blood cell count, the function of liver and kidney, the function of blood coagulation after chemotherapy in both groups were not obvious. Slight adverse reaction such as fever, dizziness and shivering was observed in a few patients. Conclusion：rhTPO can significantly reduce the degree and duration of thrombocytopenia and promote PLT recovery without severe adverse reaction for the patients with solid tumors after chemotherapy.
出处
《临床肿瘤学杂志》
CAS
2007年第12期912-914,918,共4页
Chinese Clinical Oncology
