重组人血小板生成素预防卵巢癌化疗相关血小板减少症的疗效和安全性  

Efficacy and safety of recombinant human thrombogenin in prophylactic treatment of chemotherapy-associated thrombocytopenia in ovarian cancer

作　　者：韩瑛 张晶[2] 李淑敏 桑翠琴[1] 王淑珍[1] HAN Ying;ZHANG Jing;LI Shumin;SANG Cuiqin;WANG Shuzhen(Department of Obstetrics and Gynecology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100021,China;Department of Gynecologic Oncology,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]首都医科大学附属北京朝阳医院妇产科,北京100020 [2]中国医学科学院北京协和医学院北京协和医院妇产科,北京100021 [3]国家癌症中心中国医学科学院北京协和医学院肿瘤医院妇瘤科,北京100021

出　　处：《现代肿瘤医学》2022年第10期1855-1859,共5页Journal of Modern Oncology

基　　金：北京市医管局扬帆计划重点医学专业(编号:ZYLX201713)。

摘　　要：目的:比较使用重组人血小板生成素(rhTPO)与重组人白细胞介素-11(rhIL-11)预防卵巢癌化疗相关血小板减少症(CIT)的疗效和安全性。方法:入组Ⅱ度以上卵巢癌CIT患者68例,随机分为预防性注射rhTPO治疗组(34例)和预防性注射rhIL-11治疗组(34例),化疗后第一天、第二天用药。剂量:rhTPO 300U/kg,rhIL-1125~50μg/kg。观察两组患者血小板下降情况、血小板开始恢复时间、血小板输注次数、治疗延迟及不良反应情况。结果:两组患者血小板下降程度均较本组预防性用药前有所改善,rhTPO组患者Ⅲ-Ⅳ度血小板下降比例较rhIL-11组患者明显减少,使用rhTPO的促血小板增殖效果明显高于rhIL-11。rhTPO治疗组血小板开始恢复时间与血小板恢复至100×10^(9)/L以上所需要时间较rhIL-11治疗组明显缩短,统计学差异显著。rhIL-11治疗组有1例患者化疗后输入外源性血小板,rhTPO治疗组无患者输注血小板。应用rhTPO及rhIL-11对患者凝血功能无明显影响。与rhIL-11相比,rhTPO较少发生不良反应,患者耐受性较好。结论:既往化疗出现Ⅱ度以上CIT的患者,预防性应用rhTPO和rhIL-11对CIT有积极的预防作用,rhTPO的疗效优于rhIL-11,并且具有良好的耐受性。Objective:To observe clinical effects and safety of the rhTPO and rhIL-11 in the preventive treatment of chemotherapy-associated thrombocytopenia in ovarian cancer.Methods:68 patients with ovarian cancer who have the thrombocytopenia above Ⅱ degree were randomized into two groups, 34 patients received the preventive treatment of the rhTPO,while another group received the treatment of the rhIL-11.Dosage: rhTPO 300 U/kg, rhIL-11 25~50 μg/kg.Thrombocytopenia, platelet recovery time, platelet transfusion times, delayed treatment and adverse reactions were observed in the two groups.Results:The degree of thrombocytopenia in both groups was improved compared with that before treatment, and the proportion of grade Ⅲ-Ⅳ thrombocytopenia in rhTPO group was significantly lower than that in rhIL-11 group(P<0.05).The effect of rhTPO was significantly higher than that of rhIL-11.In the rhTPO group, the start time of platelet recovery and the required time of platelet count recovered to 100×10^(9)/L was significantly shorter, the difference was significant.1 patient after treatment with rhIL-11 need transfusion of platelet, while no patient in rhTPO group.The application of rhTPO and rhIL-11 had no significant effect on the coagulation function of the patients.Compared with rhIL-11,rhTPO had fewer adverse reactions and was well tolerated by patients.Conclusion:For patients with grade Ⅱ or above thrombocytopenia, preventive use of rhTPO and rhIL-11 has a positive effect on thrombocytopenia and rhTPO is more effective than rhIL-11,with less adverse reactions.

关 键 词：重组人血小板生成素(rhTPO) 重组人白细胞介素-11(rhIL-11) 血小板减少症 

分 类 号：R737.31[医药卫生—肿瘤]