马来酸阿伐曲泊帕治疗人类免疫缺陷病毒/获得性免疫缺陷综合征合并血小板减少症1例  

Effect of Avatrombopag Maleate in the Treatment of A Case of HIV/AIDS Combined with Thrombocytopenia

作　　者：商臻 明茜 吴佳颖 袁宏艳[1] 肖毅[1] SHANG Zhen;MING Xi;WU Jiaying;YUAN Hongyan;XIAO Yi(Department of Hematology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院血液科,武汉430030

出　　处：《医药导报》2021年第10期1368-1370,共3页Herald of Medicine

基　　金：国家自然科学基金资助项目(82070213);国家自然科学基金青年项目(81700152);湖北省科技厅重点研发计划(2020BCB021);湖北省卫健委面上项目(WJ2019M126)。

摘　　要：目的探讨人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)合并血小板减少的发病机制、临床症状、实验室检查、治疗策略及风险预测。方法回顾性分析1例HIV/AIDS合并血小板减少患者的临床资料并进行文献复习。结果该例患者以口腔牙龈出血为首发症状,血常规发现重度血小板减少,血HIV抗体阳性,诊断为HIV/AIDS合并血小板重度减少,给予马来酸阿伐曲泊帕规律口服后血小板恢复至正常,后续接受高效抗逆转录病毒治疗。患者半年随访,血小板计数正常,肝功能正常,HIV感染控制良好。结论临床上血小板减少时应警惕因HIV/AIDS继发可能;治疗上可考虑使用阿伐曲泊帕长期口服,可避免激素相关感染、病毒激活以及合并抗病毒治疗时肝功能损害。Objective Among Patients with thrombocytopenia,the cases that the condition was complicated by immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)were easily being ignored in clinical work.We discussed the pathogenesis,clinical manifestations,laboratory characteristics,treatment,risk prediction and prognosis of thrombocytopenia among HIV/AIDS.Methods We retrospectively analyzed the clinical data of a patient with thrombocytopenia combined with HIV/AIDS,and reviewed related literatures.Results Gums bleeding was the only clinical symptom of the patient initially,then tests showed thrombocytopenia.The history of infectious diseases was denied.No abnormalities were found in bone marrow pathological biopsy or genetic examination.However,the antibody testing showed the HIV infection.Thus,avatrombopag maleate was selected to treat this condition until platelets count recovered to normal,then follow-up highly active antiretroviral therapy(HAART)was given.Since being diagnosed and initial treatment,the patient's platelet count has elevated to normal and HIV infection has been well controlled.Conclusion HIV/AIDS should be highly viewed when thrombocytopenia is occurred,and reasonable treatment should be conducted according to the stage of the disease.Furthermore,avatrombopag shows reliable safety and effectiveness in the treatment of thrombocytopenia among HIV/AIDS.

关 键 词：阿伐曲泊帕 马来酸 人类免疫缺陷病毒 获得性免疫缺陷综合征 血小板减少 高效抗逆转录病毒治疗 

分 类 号：R973[医药卫生—药品] R558[医药卫生—药学]