重组人血小板生成素治疗免疫性血小板减少症的疗效及安全性观察  

Efficacy and safety of rhTPO in the treatment of immune thrombocytopenia

作　　者：王景[1] 李静[1] 殷献录[1] 刘桂玲[1] 罗瑞[1] 叶隽[1] 

机构地区：[1]安徽省蚌埠市第三人民医院血液内科,233000

出　　处：《蚌埠医学院学报》2016年第7期887-890,共4页Journal of Bengbu Medical College

摘　　要：目的：观察重组人血小板生成素（rh TPO）治疗免疫性血小板减少症（ITP）的临床疗效及其安全性。方法：收集10例明确诊断的ITP患者,给予rh TPO治疗后监测血小板（PLT）计数变化,并观察药物的不良反应。结果：10例ITP患者rh TPO的总反应率[完全反应（CR）＋有效（R）]80.0%,CR率70.0%：其中新诊断ITP 6例中5例CR,1例无效（NR）;持续性ITP 1例为CR;慢性ITP 3例中CR、R和NR各1例。2例NR（20.0%）。治疗有效者（CR＋R）PLT计数升至〉30×10^9/L平均时间7.8d,PLT计数达到正常值（100×10^9/L）所需的平均时间为12 d。停用TPO后,有6例PLT计数持续正常范围,随访至2016年1月患者最长17个月维持正常PLT水平。应用rh TPO治疗期间仅1例出现手指末端血栓栓塞,予停用rh TPO,并口服血管活性药物治疗后症状消失,无后遗症。结论：rh TPO治疗ITP有较好的疗效,可以帮助患者更快、更安全地渡过严重的高风险出血期,减少PLT输注,无严重不良反应,有较好的安全性。Objective： To evaluate the efficacy and safety of recombinant human thrombopoietin（ rh TPO） in the treatment of adult immune thrombocytopenia（ ITP）. Methods： Ten patients with ITP were treated with rh TPO. The platelet counts and adverse effects in all cases after treatment were observed. Results： The total response,which included the complete response（ CR） and effectiveness（ R）,and CR rates in ITP patients were 80. 0% and 70. 0%,respectively. Among the new diagnosis of 6 cases,CR in 5 cases and non response（ NR） in 1 case were found. Among the new diagnosis of 6 cases,CR in 1 case with persistent ITP,CR,R and NR in 1 case with chronic ITP,and NR in two cases were identified. Among the effective treatment patients,the platelet count was more than 30 × 10^9/L,the average time was 7. 8 days,and the time of the platelet counts arriving at the normal value（ 100 × 10^9/L） was 12 days. After stopping the rh TPO,the platelet levels in 6 patients were normal,and the longest time of maintaining normal PLT level was 17 months.During the period of treatment with rh TPO,the finger end thromboembolism in 1 case was found,the patient was treated with stopping the rh TPO use and vasoactive drugs by oral. After treatment,the symptom disappeared,and no sequelae was found. Conclusions： The treatment of ITP with rh TPO is effective and safe,which can quickly help the patient cross the high risk of serious bleeding,reduce the amount of platelet transfusion,and has not serious adverse reactions.

关 键 词：血小板减少症 重组人血小板生成素 疗效 安全性 

分 类 号：R558.2[医药卫生—血液循环系统疾病]