TPO-RA联合rhTPO和TPO受体激动剂单药治疗放化疗所致血小板减少的疗效及安全性研究  

Efficacy and safety of TPO-RA combined with rhTPO and TPO agonist in treatment of chemoradium-induced thrombocytopenia

作　　者：何亚萌 高会霞 王彬 HE Ya-meng;GAO Hui-xia;WANG Bin(Tumor Area III,Xuchang Central Hospital,Xuchang,Henan 461000,China)

机构地区：[1]许昌市中心医院肿瘤三病区,河南许昌461000

出　　处：《医药论坛杂志》2023年第13期89-92,共4页Journal of Medical Forum

摘　　要：目的TPO受体激动剂(TPO-RA)联合重组人血小板生成素(Recombidnant human thrombopoietin,rhTPO)和TPO-RA(Thrombopoietin receptor agonist)单药治疗放化疗所致血小板减少的血小板应答情况,探讨其疗效及安全性。方法回顾性分析2022年1月—2023年1月期间许昌市中心医院肿瘤诊疗中心诊断化放疗后血小板减少的患者,联合用药组及单药组分别25例,比较两组早期应答率、早期高应答比率及完全应答时间、药物不良反应发生情况。观察时间至血小板完全应答时终止。结果联合组早期应答率低于单药组、早期应答程度高于单药组,完全应答时间均值长于单药组,联合用药组中患者3周未完全应答比例占12%,单药组中3周内均完全应答,但以上差异较单药组并无显著统计学意义。联合组出血、血栓、消化道反应、头晕头痛、疲劳乏力发生率均高于单药组,其中血栓发生率16%,相较于单药组4%升高差异有统计学意义,头晕头痛发生率84%,相较于单药组24%升高差异有统计学意义,其它不良反应差异均无统计学意义。结论较TPO-RA类药物单药应用,TPO-RA类药物与rhTPO药物联用未增加升血小板治疗的疗效,同时可能增加血栓、头晕头痛等不良反应的风险,增加患者经济方面负担。Objective To investigate the efficacy and safety of TPO-RA combined with rhTPO and TPO-RA monotherapy in the treatment of thrombocytopenia induced by chemoradiotherapy.Methods Retrospective analysis was performed on patients diagnosed with thrombocytopenia after chemoradiotherapy in Cancer Diagnosis and Treatment Center of Xuchang Central Hospital from Jan.2022 to Jan.2023,totally 25 cases in the combined drug group and the single drug group,respectively.The early response rate,early high response rate,complete response time and the occurrence of adverse drug reactions were compared between the two groups.The observation time was terminated when platelet response was complete.Results The early response rate of the combination group was lower than that of the single drug group,the early response degree was higher than that of the single drug group,and the mean complete response time was longer than that of the single drug group.In the combination group,the proportion of patients with incomplete response within 3 weeks accounted for 12%,while in the single drug group,the proportion of patients with complete response within 3 weeks was not statistically significant,but the above difference was not statistically significant compared with the single drug group.The incidence of hemorrhage,thrombosis,digestive tract reaction,dizziness,headache and fatigue in the combination group was higher than that of the monotherapy group,and the incidence of thrombosis was 16%,which was statistically significant compared with the 4%increase in the monotherapy group;the incidence of dizziness and headache was 84%,which was statistically significant compared with the 24%increase in the monotherapy group;there were no statistically significant differences in other adverse reactions.Conclusion Compared with the single application of TPO-RA drugs,the combination of TPO-RA drugs and rhTPO drugs does not increase the efficacy of platelet elevation therapy,and may increase the risk of thrombosis,dizziness,headache and other adverse reaction

关 键 词：TPO-RA联合rhTPO TPO受体激动剂 化疗后血小板减少 放疗后血小板减少 

分 类 号：R558.2[医药卫生—血液循环系统疾病]