Efficacy of recombinant human thrombopoietin in patients with acute-on-chronic liver failure and thrombocytopenia:A prospective,open-label study  

作　　者：Gang Liu Fei Tang Tao Wang Jun-Qing Yan Feng-Hui Li Fu-Shuang Ha Xu Zhang Li Jing Jing Liang 

机构地区：[1]Department of Internal Medicine,The Third Central Clinical College of Tianjin Medical University,Tianjin 300300,China [2]Department of Internal Medicine,Tianjin Dongli Hospital,Tianjin 300300,China [3]Department of Gastroenterology and Hepatology,The Third Central Hospital of Tianjin,Tianjin 300170,China [4]Department of Medical Laboratory,The Third Central Hospital of Tianjin,Tianjin 300170,China

出　　处：《World Journal of Gastroenterology》2025年第14期61-70,共10页世界胃肠病学杂志(英文)

基　　金：Supported by Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-034A.

摘　　要：BACKGROUND Patients with acute-on-chronic liver failure(ACLF)have a high mortality rate,poor prognosis,and often experience concurrent thrombocytopenia and bleeding events.AIM To evaluate the efficacy and safety of recombinant human thrombopoietin(rhTPO)in patients with ACLF with concomitant severe thrombocytopenia.METHODS This was a prospective,open-label study.We assigned 70 ACLF patients with severe thrombocytopenia into the rhTPO group and control group,with 35 patients in each group.Patients in the rhTPO group received subcutaneous injections of rhTPO at a dose of 15000 IU/day for 7 consecutive days,while patients in the control group did not receive rhTPO treatment.The primary endpoint was the proportion of patients with platelet count>50×10^(9)/L on day 14.RESULTS The proportion of patients with platelet count>50×10^(9)/L on day 14 was 60.7%in the rhTPO group,which was significantly higher than that(12.0%)in the control group(P<0.001).The platelet count in the rhTPO group on day 14 was 64×10^(9)/L,exceeding the baseline of 28×10^(9)/L.Compared to the control group,the rhTPO group exhibited a significant increase in platelet count from baseline(P<0.05).Model for end-stage liver disease score,albumin level and international normalized ratio improved significantly from baseline on day 14 after rhTPO injection.The concentrations of serum thrombopoietin and hepatocyte growth factor in the rhTPO group after 7 days were 143.7 and 195.4 pg/mL,respectively,showing a significant increase from baseline(P<0.05).Eight(22.9%)patients had bleeding events in the control group compared with four(11.4%)in the rhTPO group.The incidence of 90-day mortality was also higher in the control group(6,17.1%)than that in the rhTPO group(3,8.6%).CONCLUSION rhTPO significantly increased the platelet count in ACLF patients with thrombocytopenia and reduce the occurrence of bleeding events,with a good safety profile.

关 键 词：Recombinant human thrombopoietin Acute-on-chronic liver failure THROMBOCYTOPENIA Hepatocyte growth factor PROGNOSIS 

分 类 号：R575.3[医药卫生—消化系统]