论文部分内容阅读
目的 :研究国产全长人血小板生成素 (rhTPO)对急性髓系白血病 (AML)患者化疗后血小板减少的疗效和安全性。方法 :采用非随机自身对照。 2 8例AML诱导缓解后的患者在试验周期化疗后 ,皮下注射rhTPO1.0 μg/kg ,每日 1次 ,疗程 14d。对照周期不用rhTPO。动态观察全血细胞计数 ,定期复查肝肾功能、凝血酶原时间 (PT)、活化的部分凝血活酶时间 (aPTT)和纤维蛋白原、心电图。结果 :试验周期化疗后血小板最低值为(16 .93± 2 0 .2 7)× 10 9/L ,血小板 <2 0× 10 9/L的持续天数为 (4 .75± 5 .97)d ,输血小板的次数和量分别为 (1.5 4± 1.79)次和 (2 1.6 1± 2 9.73)u ,与对照周期相比差异均无统计学意义 (P >0 .0 5 )。化疗后血小板最高值及血小板计数恢复的增加值 (差值 )试验周期分别为 (2 5 5 .89± 2 13.0 7)× 10 9/L和 (2 38.96± 2 10 .4 3)× 10 9/L ,明显高于对照周期的 (15 0 .2 2± 10 7.6 4 )× 10 9/L和 (135 .0 7± 10 5 .75 )× 10 9/L(P <0 .0 5 )。用rhTPO对其他监测指标无明显影响。不良反应也少而轻微。结论 :国产全长rhTPO治疗AML耐受性良好 ,确实能提高AML化疗后的血小板计数 ,但对总体血小板恢复时间及血小板输注的需要没有明显影响。
Objective: To study the efficacy and safety of domestic full-length human thrombopoietin (rhTPO) in patients with acute myeloid leukemia (AML) after thrombocytopenia. Methods: Non-random self-control. Twenty-eight patients with AML-induced remission were injected subcutaneously with rhTPO 1.0 μg / kg once daily for 14 days after the experimental period of chemotherapy. Control cycle without rhTPO. Dynamic observation of whole blood count, regular review of liver and kidney function, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen, ECG. Results: The lowest value of platelet after the test period was (16.993 ± 0.2 0.27) × 10 9 / L and the platelet count of <20 × 10 9 / L was (4.75 ± 5.97) d (1.54 ± 1.79) and (2 1.6 1 ± 2 9.73) u, respectively. There were no significant differences in the number and amount of platelets transfused compared with the control period (P> 0.05). The values of the platelet count (platelet count) and platelet count recovery after chemotherapy (cycles) were (25.589 ± 2 13.0 7) × 10 9 / L and (2 38.96 ± 2 10 .4 3) × 10 9, respectively / L was significantly higher than that of the control period (15.0.22 ± 10 7.64) × 10 9 / L and (135.07 ± 105.5) × 10 9 / L (P <0.05) . With rhTPO other monitoring indicators had no significant effect. Adverse reactions are less and less. CONCLUSION: A full-length rhTPO-made domestic AML is well tolerated and indeed does increase platelet count after AML chemotherapy, but has no significant effect on overall platelet recovery time and the need for platelet transfusion.