消化系统肿瘤患者奥沙利铂相关血小板下降的临床分析

目的 探讨消化系统恶性肿瘤患者在接受含奥沙利铂方案化疗后血小板计数及脾脏直径的变化趋势，及其相关性。方法 回顾性分析72例消化系统肿瘤患者临床资料，测量及分析患者治疗期间及治疗后血小板数值及脾脏直径的变化。结果 全组72例患者各级血小板下降发生率为65.3%。化疗开始后血小板下降的中位发生时间为2.53±0.49月，中位奥沙利铂累积剂量为520±35.81 mg/m²；化疗开始后血小板最低值出现的中位时间为4.03±0.49月，中位奥沙利铂累积剂量为780±36.32 mg/m²。共有52例（72.2%）患者出现不同程度的脾脏增大；中位增大比例为（18.82±0.01）%。化疗开始后开始出现脾脏增大的中位时间为2.15±0.19月，脾脏直径最大的中位时间为4.68±2.89月，化疗结束后脾脏开始缩小的中位时间为3.28±0.44月，化疗结束后脾脏恢复的中位时间为8.80±1.05月。结论 含奥沙利铂方案的化疗可引起血小板下降、脾脏肿大，并且在化疗结束后较长时间难以恢复到基线水平。脾脏径线增加与脾肿大和血小板下降具有显著相关性。

Clinical Analysis of Oxaliplatin-related Thrombocytopenia in Patients with DigestiveSystem Malignancy

Objective To investigate the changing trend and correlation of platelet count and spleen diameter in patients with digestive system malignancy receiving oxaliplatin-based chemotherapy. Methods We retrospectively analyzed clinical data of 72 patients with digestive system cancer, recorded and analyzed platelet count and spleen diameter during and after oxaliplatin-based chemotherapy. Results The incidence of thrombocytopenia in all patients was 65.3%. The median time of thrombocytopenia after the beginning of chemotherapy was 2.53±0.49 months, and the median cumulative dose of oxaliplatin was 520±35.81 mg/m²; the median time of lowest platelet count after the beginning of chemotherapy was 4.03±0.49 months, and the median cumulative dose of oxaliplatin was 780±36.32 mg/m². Splenomegaly occurred in 52(72.2%) patients during the follow-up. The median increase rate was (18.82±0.01)%. The median time of splenomegaly after the beginning of chemotherapy was 2.15±0.19 months, the median time for the largest spleen diameter was 4.68±2.89 months; after the end of chemotherapy, the median time for spleen contraction was 3.28±0.44 months, and the median time for spleen recovery was 8.80±1.05 months. Conclusion Oxaliplatin-based chemotherapy can cause thrombocytopenia and splenomegaly, and it is difficult to recover to baseline for a long time after the end of chemotherapy. The increase of spleen diameter was positively correlated with splenomegaly and thrombocytosis.