CAJ | 학술논문

目的评价短程间歇预防性给予重组人血小板牛成素(rhTPO)治疗肺癌化疗诱导的严重血小板减少的临床疗效.方法前一个化疗周期(对照周期)发生严重血小板减少的24例非小细胞肺癌(NSCLC)患者,在进入下一个化疗周期时(预防用药周期)短程间歇预防性给予rhTPO,即化疗开始后的第2、4、6、9天给予rhTPO 300 U·ks-1·d-1皮下注射,监测患者的血小板计数变化,并进行对比分析.结果预防用药周期中患者血小板计数最低值为(56±16)×IO9/L,对照周期为(28±13)×109/L(P<0.001).预防用药周期中患者血小板减少的持续时间为(8 4±2)d,对照周期为(12±3)d(P<0.001).预防用药周期中患者血小板计数曲线下面积为(3517±685)×109/L,对照周期为(2063±436)×10'/L(P<0.001).预防用药周期和财照周期中患者化疗后血小板计数最低值出现时间和血小板计数恢复最大值之间差异均无统计学意义(均P>0.05).结论对于既往有化疗诱导的严重血小板减少发生史的NSCLC患者,短程间歇预防性给予rhTPO,可降低患者血小板减少的严重程度,并缩短血小板减少的持续时间.
목적 평개단정간헐예방성급여중조인혈소판우성소(rhTPO)치료폐암화료유도적엄중혈소판감소적림상료효.방법 전일개화료주기(대조주기)발생엄중혈소판감소적24례비소세포폐암(NSCLC)환자,재진입하일개화료주기시(예방용약주기)단정간헐예방성급여rhTPO,즉화료개시후적제2、4、6、9천급여rhTPO 300 U·ks-1·d-1피하주사,감측환자적혈소판계수변화,병진행대비분석.결과 예방용약주기중환자혈소판계수최저치위(56±16)×IO9/L,대조주기위(28±13)×109/L(P<0.001).예방용약주기중환자혈소판감소적지속시간위(8 4±2)d,대조주기위(12±3)d(P<0.001).예방용약주기중환자혈소판계수곡선하면적위(3517±685)×109/L,대조주기위(2063±436)×10'/L(P<0.001).예방용약주기화재조주기중환자화료후혈소판계수최저치출현시간화혈소판계수회복최대치지간차이균무통계학의의(균P>0.05).결론 대우기왕유화료유도적엄중혈소판감소발생사적NSCLC환자,단정간헐예방성급여rhTPO,가강저환자혈소판감소적엄중정도,병축단혈소판감소적지속시간.
Objective To evaluate the efficacy of short-term intermittent prophylactic use of a recombinant human thrombopoietin ( rhTPO) in chemotherapy-induced severe thrombocytopenia in lung cancer patients. Methods 24 advanced non-small cell lung cancer ( NSCLC) patients who experienced severe thrombocytopenia in the last chemotherapy cycle received prophylactic rhTPO treatment in the next chemotherapy cycle (prophylactic treated cycle, PTC). rhTPO was given subcutaneously 300 U ·kg-1· d-1 on days 2, 4, 6, and 9 after the initiation of chemotherapy. Platelet count was monitored and compared with that in the previous treatment cycle (control cycle, CC ). Results The lowerest platelet count in the prophylactic rhTPO cycle was significantly higher than that in control cycle [(56 ± 16)×109/L vs. ( 28 ± 13) × 10'/L, P < 0.001]. The duration of thrombocytopenia was also shortened by the prophylactic rhTPO [(8±2) d vs. (12 ±3) d, P<0.001]. The area under curve (AUC) of platelet count (21 days) was significantly increased [(3517 ± 685 ) x 109/L vs. (2063 ± 436)×109/L, P < 0. 001]. The time to platelet nadir and peak was not affected. Conclusion Prophylactic use of rhTPO can attenuate the severity and shorten the duration of chemotherapy-induced thrombocytopenia in lung cancer patients.