脾肿大对阿伐曲泊帕治疗肝硬化患者血小板减少症的影响  

Effect of splenomegaly on treatment of thrombocytopenia with avatrombopag in patients with liver cirrhosis

作　　者：袁莉莉 张蕊[1] 何怡 鲁东 徐少保 徐静[1] YUAN Li-li;ZHANG Rui;HE Yi;LU Dong;XU Shao-bao;XU Jing(Department of Infectious Disease,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of Chin1,Hefei ANHUI 230000,China;Department of Interventional Radiology,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of Chin1,Hefei ANHUI 230000,China)

机构地区：[1]中国科学技术大学附属第一医院/安徽省立医院感染科,安徽合肥230000 [2]中国科学技术大学附属第一医院/安徽省立医院介入科,安徽合肥230000

出　　处：《中国新药与临床杂志》2025年第1期43-47,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：安徽省公益性研究联动计划项目(15011d04029)。

摘　　要：目的研究脾肿大程度对阿伐曲泊帕治疗肝硬化患者血小板(PLT)减少症的影响。方法回顾性分析2020年10月至2022年9月本院应用阿伐曲泊帕(60 mg,qd×5 d)治疗的101例肝硬化合并PLT减少症患者的病例资料。将患者分无脾肿大组及轻度、中度和重度脾肿大组,记录不同程度脾脏肿大患者应用阿伐曲泊帕后不同时间的PLT计数,分析脾肿大程度与PLT的关系。结果阿伐曲泊帕治疗后,101例患者中有71例(70.3%)PLT较基线上升≥100%,有79例(78.2%)PLT≥50×10^(9)·L^(-1)。治疗开始后不同时间各组PLT与基线比较均显著升高(P<0.05);10~13 d各组PLT与3~5 d相比均显著升高(P<0.05),不同程度脾肿大组与无脾肿大组间均有非常显著差异(P<0.01);28~30 d各组PLT与10~13 d相比均显著下降(P<0.05),不同程度脾肿大组与无脾肿大组间无显著差异(P>0.05)。各时间不同程度脾肿大组间PLT无显著差异(P>0.05)。多因素分析结果显示,脾肿大程度不是影响阿伐曲泊帕应答的独立危险因素。结论阿伐曲泊帕对肝硬化合并PLT减少症患者升高PLT的效果显著,疗效不因患者的脾肿大程度而存在差异。AIM To study the effect of splenomegaly on treatment of thrombocytopenia with avatrombopag in patients with liver cirrhosis.METHODS Clinical data of 101 patients with liver cirrhosis and thrombocytopenia treated with avatrombopag(60 mg,qd×5 d)in our hospital from October 2020 to September 2022 were retrospectively analyzed.The patients were divided into four groups:non-splenomegaly group and mild,moderate and severe splenomegaly group.PLT counts of patients with different degrees of splenomegaly were recorded at different treatment times after application of avatrombopag,and the relationship between the degree of splenomegaly and PLT counts was analyzed.RESULTS After treatment with avatrombopag,71(70.3%)of 101 patients had PLT increase 100%from baseline,and 79(78.2%)patients had PLT≥50×10^(9)·L^(-1).PLT in each group significantly increased compared with baseline at different time points after the start of treatment(P<0.05).After 10-13 days of treatment,the PLT levels in all groups were significantly increased compared with 3-5 days(P<0.05),and there were significant differences between the groups with different degrees of splenomegaly and non-splenomegaly group(P<0.01).After 28-30 days of treatment,the PLT levels in all groups were significantly decreased compared with 10-13 days(P<0.05),and there were no significant differences between the groups with different degrees of splenomegaly and non-splenomegaly group(P>0.05).There were no significant differences in PLT among groups with different degrees of splenomegaly at different times(P>0.05).Multivariate analysis showed that the degree of splenomegaly was not an independent risk factor affecting the response to avatrombopag.CONCLUSION Avatrombopag has a significant effect on increasing PLT in patients with liver cirrhosis and thrombocytopenia,and the therapeutic effect does not differ due to the degree of splenomegaly in patients.

关 键 词：脾肿大 阿伐曲泊帕 肝硬化 血小板减少症 

分 类 号：R442.3[医药卫生—诊断学] R973[医药卫生—临床医学]