重组人血小板生成素治疗恶性肿瘤化疗所致血小板减少症的Meta分析  

Meta-analysis of recombinant human thrombopoietin in treatment of chemotherapy-induced thrombocytopenia in patients with malignancy

作　　者：程涵 黄婧 吴进[2] 李娜[2] CHENG Han;HUANG Jing;WU Jin;LI Na(Department of Cardiothoracic Surgery,Chengdu Second People's Hospital,Chengdu 610017,Sichuan,CHINA;Department of Oncology,West China Fourth Hospital of Sichuan University,Chengdu 610041,Sichuan,CHINA)

机构地区：[1]成都市第二人民医院胸心外科,四川成都610017 [2]四川大学华西第四医院肿瘤科,四川成都610041

出　　处：《海南医学》2020年第17期2276-2284,共9页Hainan Medical Journal

摘　　要：目的评估重组人血小板生成素(rhTPO)和重组人白细胞介素-11(rhIL-11)治疗恶性肿瘤化疗后血小板减少症(CIT)的有效性及安全性。方法通过计算机检索中国知网、维普中文期刊数据库、万方数据库、中国科技期刊数据库、Cochrane图书馆、Embase及PubMed。搜索rhTPO及rhIL-11治疗CIT的所有随机对照试验,检索时限均从建库至2019年7月。由2名作者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 14.0软件进行Meta分析。结果共纳入34篇随机对照研究,合计2186例患者。Meta分析显示,rhTPO在化疗后缩短血小板恢复至≥75×109/L[SMD-1.69,95%CI(-1.98,-1.39),P<0.001]、血小板恢复至≥(100~125)×109/L[SMD-1.46,95%CI(-1.70,-1.22),P<0.001]的时间、血小板的最高值[SMD 1.031,95%CI(0.74,1.323),P<0.001]、血小板≤50×109/L的持续时间[SMD-1.35,95%CI(-1.57,-1.13),P<0.001]、降低不良反应发生率[RR 0.31,95%CI(0.25,0.38),P<0.001]及血小板输注概率[RR 0.50,95%CI(0.30,0.85),P=0.01]方面均优于rhIL-11。结论rhTPO在提高血小板最高值、缩短血小板减少的持续时间方面均优于rhIL-11,且不良反应发生率及血小板输注比例更低。Objective To evaluate the efficacy and safety of recombinant human thrombopoietin(rhTPO)and recombinant human interleukin-11(rhIL-11)in the treatment of chemotherapy-induced thrombocytopenia(CIT).Methods CNKI,VIP database,Wanfang data,CSTJ databases,Cochrane library,Embase and PubMed were electronically searched.All randomized controlled trials involving clinical application of rhTPO and rhIL-11 were included,and the censor date was from the time of building database to July 2019.After independent literature screening,data extraction and evaluation of the risk of bias in the included studies by two researchers,and meta-analysis was performed using Stata 14.0 software.Results A total of 34 randomized controlled trials including 2186 patients were included.The meta-analysis showed that rhTPO was better than that of rhIL-11 in terms of shortening the time for platelet elevating above 75×109/L(SMD-1.69,95%CI[-1.98,-1.39],P<0.001)and(100-125)×109/L(SMD-1.46,95%CI[-1.70,-1.22],P<0.001)after chemotherapy,shortening the time interval for recovery after chemotherapy to maximum platelet values(SMD 1.031,95%CI[0.74,1.323],P<0.001)and duration of platelet values less than 50×109/L(SMD-1.35,95%CI[-1.57,-1.13],P<0.001),reducing adverse reaction rate(RR 0.31,95%CI[0.25,0.38],P<0.001)and proportion of platelet infusion(RR 0.50,95%CI[0.30,0.85],P=0.01).Conclusion rhTPO is better than rhIL-11 in enhancing the platelet count and shorting the duration of thrombocytopenia.Besides,it has less adverse effect and low incidence of platelet infusion rate.

关 键 词：重组人血小板生成素 重组人白细胞介素11 化疗 血小板减少症 META分析 

分 类 号：R730.53[医药卫生—肿瘤]