摘要
目的：观察重组人血小板生成素（rhTPO）对脓毒症相关性血小板减少症的疗效和安全性。方法：将60例脓毒症相关性血小板减少症患者随机分成TPO组和对照组。在常规治疗的基础上,TPO组给予rhTPO15 000U皮下注射,1次/d,不超过7d;对照组给予常规治疗7d。观察第1-7天2组患者血小板计数,凝血功能,出血况和血制品输注况,肝、肾功能,ICU住院时间,ICU病死率和药物不良反应。结果：治疗后第3-7天,TPO组血小板计数（×10-9/L）[第3天（80.22±15.17）,第5天（100.35±19.51）,第7天（107.55±6.23）]明显高于对照组[第3天（60.49±15.34）,第5天（68.28±18.04）,第7天（81.16±18.82）];TPO组用药后血小板恢复≥100×109/L,所用天数（5.45±1.28）d明显少于对照组（8.35±1.14）d;TPO组血小板等血制品输注量[血小板（1.5±1.2）U,新鲜冰冻血浆（60.5±40.3）ml,浓缩红细胞（0.4±0.5）U]明显少于对照组[（血小板（3.3±1.8）U,新鲜冰冻血浆（133.3±101.8）ml,浓缩红细胞（1.2±1.2）U];TPO组ICU病死率（20%）明显低于对照组（40%）;TPO组出血发生率和ICU住院时间低于对照组,差异无统计学意义;2组凝血功能和用药前后肝、肾功能差异均无统计学意义;2组均无药物不良反应发生。结论：rhTPO能够明显升高脓毒症相关性血小板减少症患者的血小板计数,明显减少患者输注浓缩血小板等血制品的数量,缩短ICU住院时间,显著降低患者的病死率,同时对肝、肾功能无影响,未见药物不良反应,值得临床进一步研究和推广应用。
Objective：To evaluate the efficacy and safety of recombinant human thrombopoietin（rhTPO）in patients with sepsis-associated thrombocytopenia.Method：Sixty patients with sepsis-associated thrombocytopenia were randomly divided into two groups：TPO group and control group.The patients of TPO group were given conventional treatment and TPO 15000 Usubcutaneously daily for no more than 7days,and the patients in control group were only given conventional treatment.The platelet count,the coagulation function,the bleeding incidence,the amount of blood product transfusion,the length of ICU stay and ICU mortality,the hepatic function,the renal function and the adverse reaction were collected and compared between the two groups.Result：The mean platelet counts（×10~9/L）in the TPO group [the 3rd day（80.22±15.17）,the 5th day（100.35±19.51）,the 7th day（107.55±6.23）]was significantly higher than those in the control group [the 3rd day（60.49±15.34）,the 5th day（68.28±18.04）,the 7th day（81.16±18.82）].The time required for the platelet count to return to normal in the TPO group（5.45±1.28）d is significantly shorter than that in the control group（8.35±1.14）d.The amount of platelet and other blood product transfusion were significantly less in the TPO group [platelet（1.5±1.2）U,fresh frozen plasma（60.5±40.3）ml,concentrated red blood cells（0.4±0.5）U]than those in the control group[platelet（3.3±1.8）U,fresh frozen plasma（133.3±101.8）ml,concentrated red blood cells（1.2±1.2）U].The ICU mortality of the TPO group（20%）is significantly lower than that of the control group（40%）.The incidence of bleeding and the length of ICU stay in the TPO group is less than that in the control group,but there are no statistical differences.There were no statistical differences in the coagulation function,the hepatic and renal function between the two groups.There was no serious adverse reaction associated with drug use.Conclusion：The use of rhTPO is safe and can significantly increase the platelet count,decrease the amount of blood product transfusion,and decrease the ICU mortality in patients with sepsis-associated thrombocytopenia.rhTPO is safe when treating these patients.
出处
《临床急诊杂志》
CAS
2016年第9期663-667,共5页
Journal of Clinical Emergency
