rhTPO联合激素治疗成人ITP的疗效及安全性分析

Analysis of the Efficacy and Safety of rhTPO Combined with Hormone in the Treatment of Adult ITP

摘要: 目的：探讨重组人血小板生成素(rhTPO)联合标准剂量糖皮质激素在治疗成人原发免疫性血小板减少症(ITP)方面的短期疗效及安全性。方法：选取2018年1月1日至2024年6月1期间北华大学附属医院血液科收治的93例ITP患者进行回顾性分析，根据治疗方法的不同，将患者分为研究组(46例)和对照组(47例)，对照组患者给予标准剂量醋酸泼尼松片治疗，研究组患者在标准剂量醋酸泼尼松片基础上联合重组人血小板生成素治疗，比较两组患者治疗前及治疗后第3、7、14 d时PLT水平的变化情况、PLT增幅情况以及总有效率，观察药物的不良反应。结果：研究组与对照组治疗后的PLT与治疗前相比较，均高于治疗前水平，研究组在治疗后d14，PLT数值、较用药前PLT升高程度均显著高于对照组(P < 0.05)；研究组总有效率明显高于对照组(95.7% vs 78.7%)，差异有统计学意义(P < 0.05)；研究组与对照组患者低血钾、白细胞增高、肌肉酸痛、肝酶升高、胃肠道不适等不良反应总发生率比较差异无统计学意义(P > 0.05)。结论：重组人血小板生成素联合标准剂量糖皮质激素治疗原发免疫性血小板减少症的短期疗效较显著，可明显升高PLT计数，且安全性较好，不会出现严重的不良反应。

Abstract: Objective: Investigate the short-term therapeutic effect and safety of recombinant human thrombopoietin (rhTPO) in conjunction with standard-dose glucocorticoids for the treatment of adult primary immune thrombocytopenia (ITP). Method: A retrospective analysis was performed on 93 patients with immune thrombocytopenia (ITP) admitted to the Hematology Department of Affiliated Hospital of Beihua University from January 1, 2018 to June 1, 2024. They were separated into a study group with 46 cases and a control group containing 47 cases. Patients in the control group were given standard-dose prednisone acetate tablets, while patients in the study group were treated with recombinant human thrombopoietin in addition to standard-dose prednisone acetate tablets. The changes in platelet count (PLT) levels before treatment and on the 3rd, 7th, and 14th days after treatment, as well as platelet increase and total effective rate, were compared between the two groups. Adverse drug reactions were also observed. Results: Compared with before treatment, the PLT of the study group and the control group after treatment was higher than that before treatment. On day 14 after treatment, the PLT value and the increase degree of PLT compared with that before medication in the study group were significantly higher than those in the control group (P < 0.05). The overall effective rate of the study group was notably higher than that of the control group (95.7% versus 78.7%), and the disparity was statistically significant (P < 0.05).There was no statistically significant difference in the total incidence of adverse reactions such as hypokalemia, elevated white blood cell count, muscle soreness, elevated liver enzymes, and gastrointestinal discomfort between the experimental group and the control group (P > 0.05). Conclusions: The clinical efficacy of recombinant human thrombopoietin combined with standard-dose glucocorticoid in the treatment of primary immune thrombocytopenia is outstanding. It can significantly increase the platelet count and has good safety without serious adverse reactions.