摘要目的 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.

abstractsObjective 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.