中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
3期
181-185
,共5页
张莉%杨文睿%叶蕾%周康%井丽萍%李洋%李园%李建平%彭广新
張莉%楊文睿%葉蕾%週康%井麗萍%李洋%李園%李建平%彭廣新
장리%양문예%협뢰%주강%정려평%리양%리완%리건평%팽엄신
贫血,再生障碍性%血小板生成素%免疫抑制法%治疗结果
貧血,再生障礙性%血小闆生成素%免疫抑製法%治療結果
빈혈,재생장애성%혈소판생성소%면역억제법%치료결과
Anemia,aplastic%Thrombopoietin%Immunosuppression%Treatment outcome
目的 评价重组人血小板生成素(rhTPO)对重型再生障碍性贫血(SAA)免疫抑制治疗(IST)近期疗效的影响.方法 回顾性分析IST联合rhTPO治疗40例成人SAA患者,以同期单用标准IST方案的患者为对照组,比较两组患者血液学反应及血小板恢复情况,并分析影响近期疗效的相关因素.结果 IST后3个月,rhTPO组患者血液学反应率及良好血液学反应率均明显高于对照组(75.0％对50.0％,P=0.025;17.5％对2.5％,P=0.022).IST后6个月,rhTPO组与对照组患者血液学反应率分别为77.5％和57.5％,差异无统计学意义(P=0.058),但rhTPO组良好血液学反应率高于对照组(45.0％对22.5％,P=0.033).rhTPO组患者脱离血小板输注时间较对照组短[33(0～90)d对53(0～75)d,P=0.019],血小板输注中位量也明显低于对照组.IST后3个月rhTPO组患者PLT中位数为29(4～95)×109/L,明显高于对照组的15(5～94)×109/L(P=0.006).两组患者预期3年生存率比较差异无统计学意义(100.0％对91.0％,P=0.276).结论 rhTPO可提高SAA的IST血液学反应率,加快血小板恢复.
目的 評價重組人血小闆生成素(rhTPO)對重型再生障礙性貧血(SAA)免疫抑製治療(IST)近期療效的影響.方法 迴顧性分析IST聯閤rhTPO治療40例成人SAA患者,以同期單用標準IST方案的患者為對照組,比較兩組患者血液學反應及血小闆恢複情況,併分析影響近期療效的相關因素.結果 IST後3箇月,rhTPO組患者血液學反應率及良好血液學反應率均明顯高于對照組(75.0％對50.0％,P=0.025;17.5％對2.5％,P=0.022).IST後6箇月,rhTPO組與對照組患者血液學反應率分彆為77.5％和57.5％,差異無統計學意義(P=0.058),但rhTPO組良好血液學反應率高于對照組(45.0％對22.5％,P=0.033).rhTPO組患者脫離血小闆輸註時間較對照組短[33(0～90)d對53(0～75)d,P=0.019],血小闆輸註中位量也明顯低于對照組.IST後3箇月rhTPO組患者PLT中位數為29(4～95)×109/L,明顯高于對照組的15(5～94)×109/L(P=0.006).兩組患者預期3年生存率比較差異無統計學意義(100.0％對91.0％,P=0.276).結論 rhTPO可提高SAA的IST血液學反應率,加快血小闆恢複.
목적 평개중조인혈소판생성소(rhTPO)대중형재생장애성빈혈(SAA)면역억제치료(IST)근기료효적영향.방법 회고성분석IST연합rhTPO치료40례성인SAA환자,이동기단용표준IST방안적환자위대조조,비교량조환자혈액학반응급혈소판회복정황,병분석영향근기료효적상관인소.결과 IST후3개월,rhTPO조환자혈액학반응솔급량호혈액학반응솔균명현고우대조조(75.0％대50.0％,P=0.025;17.5％대2.5％,P=0.022).IST후6개월,rhTPO조여대조조환자혈액학반응솔분별위77.5％화57.5％,차이무통계학의의(P=0.058),단rhTPO조량호혈액학반응솔고우대조조(45.0％대22.5％,P=0.033).rhTPO조환자탈리혈소판수주시간교대조조단[33(0～90)d대53(0～75)d,P=0.019],혈소판수주중위량야명현저우대조조.IST후3개월rhTPO조환자PLT중위수위29(4～95)×109/L,명현고우대조조적15(5～94)×109/L(P=0.006).량조환자예기3년생존솔비교차이무통계학의의(100.0％대91.0％,P=0.276).결론 rhTPO가제고SAA적IST혈액학반응솔,가쾌혈소판회복.
Objective To evaluate the impact of recombinant human thrombopoietin (rhTPO) on short-term response of immunosuppressive therapy (IST) in patients with newly diagnosed acquired severe aplastic anemia (SAA).Methods The clinical data of forty adult acquired SAA patients,who treated with IST combined with rhTPO,were retrospective analyzed and the hematologic recovery were compared with patients by the IST alone during the same period.The factors affecting the short-term response were also analyzed.Results At 3 months after IST,both the total response rate and CR+GPR rate in rhTPO group were much higher than those in control group (75.0％ vs 50.0％,P=0.022; and 17.5％ vs 2.5％,P=0.025).At 6 months after IST,there was no difference of total hematologic response rate in rhTPO group and control group (77.5％ vs 57.5％,P=0.058),while the CR+GPR rate was still higher in rhTPO group (45.0％ vs 22.5％,P=0.033).The median time of platelet transfusion independence was much shorter in rhTPO group [33 (0-90) vs 53 (0-75) d,P=0.019].Patients in rhTPO group needed less platelets transfusion support.The median platelet count in rhTPO group was 29(4-95)× 109/L at 3 months after IST,which was much higher than that in control group [29 (4-95) × 109/L,P=0.006].There was no significant difference regarding overall survival between the two groups (100.0％ vs 91.0％,P=0.276).Conclusion rhTPO is effective in promoting platelet recovery and improving the hematopoietic response for SAA patients with IST.
