重组人血小板生成素预防吉西他滨化疗相关血小板减少症的临床观察

目的：观察重组人血小板生成素（rhTPO）对吉西他滨相关血小板减少症（CIT）的预防作用。方法选择采用含吉西他滨化疗方案治疗出现Ⅱ级及以上血小板减少的恶性肿瘤患者74例，随机分为预防性注射重组人血小板生成素组（rhTPO组）和预防性注射重组人白细胞介素-11组（rhIL-11组），在化疗的d3、d5、d7、d9，对rhTPO组和rhIL-11组患者分别进行皮下注射rhTPO和rhIL-11治疗，观察两组患者血小板下降情况、血小板开始恢复时间、血小板输注次数、治疗延迟及不良反应情况。结果预防性治疗后，两组患者血小板下降程度均较本组治疗前有改善，且rhTPO组患者Ⅲ~Ⅳ级血小板下降比例较rhIL-11组患者减少（P﹤0.05）；rhTPO组患者血小板开始恢复时间明显较rhIL-11组提前（P﹤0.01）；rhTPO组患者d8延迟、下周期（d22）延迟及心律失常发生率均较rhIL-11组降低（P﹤0.05）。结论预防性应用rhTPO和rhIL-11对CIT有积极的预防作用，rhTPO的疗效优于rhIL-11，且不良反应较轻。

Clinical observation of predosing recombinant human thrombopoietin in the gemcitabine chemotherapy-induced thrombocytopenia

Objective To evaluate the efficacy and safety of recombinant human thrombopoietin (rhTPO) in gem-citabine chemotherapy-induced thrombocytopenia. Method 74 cases of malignant tumor patients with thrombocytope-nia of gradeⅡor higher after gemcitabine-based chemotherapy were included and randomized as rhTPO group or rhIL-11 group, administered with subcutaneous injection of rhTOP or rhIL-11 on d3, d5, d7, and d9, respectively, the platelet count, time to platelet recovery, platelet transfusions, delayed treatment and adverse reactions in the two groups were ob-served. Result Predosing of rhTPO and rhIL-11 improved the thrombocypenia in all patients, and the proportion of pa-tients with thrombocytopenia of gradeⅢ~Ⅳin rhTOP group were less than those in rhIL-11 group (P<0.05);rhTOP group had shorter time to platelet recovery than rhIL-11 group (P<0.01);The incidence of delayed treatment on d8, de-layed treatment of next cycle (d22), as well as incidence of arrhythmia were decreased in rhTOP group than those in rhIL-11 group (P<0.05). Conclusion Predosing rhTPO and rhIL-11 are both effective and safe for preventing CIT, and rhTPO is superior than rhIL-11 in respect of response rate, with minor adverse reactions.