重组人血小板生成素联合免疫球蛋白治疗脓毒症相关性血小板减少症疗效评价  

Efficacy of Recombinant Human Thrombopoietin Combined with Immunoglobulin in the Treatment of Sepsis-Related Thrombocytopenia

作　　者：彭秋琰 洪燕 刘光明 宋永玲 王强 熊雨美 朱翠平 PENG Qiuyan;HONG Yan;LIU Guangming;SONG Yongling;WANG Qiang;XIONG Yumei;ZHU Cuiping(Guangzhou Women and Children Medical Center,Guangzhou,Guangdong,China 510120)

机构地区：[1]广东省广州市妇女儿童医疗中心,广东广州510120

出　　处：《中国药业》2021年第3期25-27,共3页China Pharmaceuticals

基　　金：广东省自然科学基金[2015A030313682]。

摘　　要：目的探讨重组人血小板生成素(rhTPO)联合静脉注射人免疫球蛋白(IVIG)治疗脓毒症相关性血小板减少症的疗效及安全性。方法选取医院2016年5月至2019年6月收治的脓毒症合并血小板减少症患者90例,随机分为观察组(行rhTPO联合IVIG治疗)和对照组(行IVIG治疗),各45例。结果观察组急性生理和慢性健康状况Ⅲ评分(APACHE-Ⅲ)、外周血血小板(PLT)计数、血浆肿瘤坏死因子-α(TNF-α)、血管性血友病因子(v WF)和干扰素-γ(IFN-γ)水平均显著优于对照组(P<0.05)。观察组血小板、浓缩红细胞及血浆输注量均显著低于对照组(P<0.05),PLT水平恢复正常时间、住重症监护病房(ICU)时间均显著低于对照组(P<0.05);两组均未发生严重不良反应。结论rhTPO联合IVIG治疗脓毒症相关性血小板减少症能有效纠正血小板减少,进而减少血液制品的使用,改善预后,缓解炎症,治疗效果佳,且安全性好。Objective To investigate the efficacy and safety of recombinant human thrombopoietin(rhTPO)combined with intravenous immunoglobulin(IVIG)in the treatment of sepsis-related thrombocytopenia.Methods Totally 90 patients with sepsis and thrombocytopenia admitted to our hospital from May 2016 to June 2019 were selected and randomly divided into the observation group(treated with rhTPO combined with IVIG)and the control group(treated with IVIG),45 cases in each group.Results After treatment,the scores of Acute Physiology and Chronic Health EvaluationⅢ(APACHE-Ⅲ),the count of platelet(PLT)in peripheral blood,the levels of plasma tumor necrosis factor-α(TNF-α),von Willebrand factor(vWF)and interferon-γ(IFN-γ)in the observation group were significantly better than those in the control group(P<0.05).The infusion volume of PLT,concentrated red blood cells and plasma in the observation group was significantly lower than that in the control group(P<0.05),the time of PLT returning to normal and intensive care unit(ICU)stay time in the observation group were significantly shorter than those in the control group(P<0.05).No serious adverse reactions occurred in both groups.Conclusion rhTPO combined with IVIG in the treatment of sepsis-related thrombocytopenia can effectively correct thrombocytopenia,reduce the usage of blood products,improve prognosis,and relieve inflammation,it has good curative effect and safety.

关 键 词：重组人血小板生成素 静脉注射人免疫球蛋白 脓毒症 血小板减少症 临床疗效 安全性 

分 类 号：R973[医药卫生—药品]