重组人血小板生成素对肺癌化疗患者血小板输注效果的影响
|
摘要
目的评估肺癌化疗患者预防性使用重组人血小板生成素(rhTPO)对化疗后输注血小板效果的影响。方法应用临床输血智能管理与评估系统(v1. 0),选取本院2015年1月1日—12月31日输注血小板的276名肺癌化疗患者的病历资料,按照是否曾使用rhTPO将患者分为rhTPO组(n=146)和对照组(n=130),比较2组患者年龄、性别、体表面积、体重指数(BMI)、输前血小板计数(Plt)等基线资料,以及血小板输注效果(以血小板校正增高指数判断输注疗效)、输注量。结果 2组患者基线资料数据相近(P>0. 05); rhTPO组146例共输注血小板407 U、对照组130例共输注血小板379 U,2组患者平均血小板输注量(U)分别为2. 97±0. 34 vs 3. 81±0. 14(P<0. 05); 2组患者输注总体为有效(P<0. 05); 2组输注血小板前后均检测血常规的患者比例分别为73. 97%(108/146) vs 76. 15%(99/130),输注有效率分别为86. 9%(279/321) vs 76. 5%(235/307)(P<0. 05)。结论肺癌化疗患者预防性使用rhTPO可减少化疗后异体血小板输注量,且血小板输注效果较未使用rhTPO者高。
Objective To evaluate the effect of recombinant human platelet product(rhTPO) on lung cancer patients with chemotherapy. Methods With application of the intelligent management and evaluation system for clinical blood transfusion(v1.0),we selectd the patients with lung cancer recorded during January 1,2015 to December 31,2015. The patients were divided into the rhTPO group(n = 146) and the control group(n = 130),comparing the baseline indexes( age,sex,body mass index,body surface area,platelet count pretransfusion),the effects of platelet transfusion,and Infusion quantity.Results The baseline indexes of the two groups showed no statistically significant differences(P<0. 05); Transfusion volume: 146 cases of rhTPO group(407U),130 cases of control group( 379 U). The mean platelet infusion volume( U) of the two groups was 2. 97±0. 34,3. 81±0. 14( P<0. 05); The infusion was effective in both groups(P<0. 05); The proportion of patients in the group with blood routine examination pre and post platelet transfusion was 73. 97%(108/146) and76. 15%( 99/130),The effective rates of infusion were 86. 9%( 279/321) and 76. 5%(235/307),respectively(P <0. 05).Conclusion The application of rhTPO can significantly reduce the amount of platelets transfusion,and improve the effect in lung cancer patients with chemothery.
Objective To evaluate the effect of recombinant human platelet product(rhTPO) on lung cancer patients with chemotherapy. Methods With application of the intelligent management and evaluation system for clinical blood transfusion(v1.0),we selectd the patients with lung cancer recorded during January 1,2015 to December 31,2015. The patients were divided into the rhTPO group(n = 146) and the control group(n = 130),comparing the baseline indexes( age,sex,body mass index,body surface area,platelet count pretransfusion),the effects of platelet transfusion,and Infusion quantity.Results The baseline indexes of the two groups showed no statistically significant differences(P<0. 05); Transfusion volume: 146 cases of rhTPO group(407U),130 cases of control group( 379 U). The mean platelet infusion volume( U) of the two groups was 2. 97±0. 34,3. 81±0. 14( P<0. 05); The infusion was effective in both groups(P<0. 05); The proportion of patients in the group with blood routine examination pre and post platelet transfusion was 73. 97%(108/146) and76. 15%( 99/130),The effective rates of infusion were 86. 9%( 279/321) and 76. 5%(235/307),respectively(P <0. 05).Conclusion The application of rhTPO can significantly reduce the amount of platelets transfusion,and improve the effect in lung cancer patients with chemothery.
引文
[1]谢军花,叶菲,吴莉莉,等.血小板输注无效的回顾性调查分析.临床血液学杂志,2016,29(8):662-663.
[2]陈超,郭代红,季晓英,等.重组人血小板生成素的临床应用综合评价.中国药物应用与监测2011 8(1):5-8
[3]胡小秀,罗会芹,陈文菊等.吉西他滨联合柏类治疗晚期非小细胞肺癌临床疗效观察.临床军医杂志,2018,46(4):561-563.
[4]钟辉,闫晓红,崔翠花.重组人血小板生成素预防吉西他滨化疗相关血小板减少症的临床观察.癌症进展,2016,14(10):1010-1012.
[5]Brown T.Pilkington G.Bagust A,et al.Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic nonsmall cell lung cancer:a systematic review and economic evaluation.Health Technol Assess,2013,17(31):1-278.
[6]Lee HS,Park SW.Systemic chemotherapy in advanced pancreatic cancer.Gut Liver,2016,10(3):340-347.
[7]Hernandez-Aya LF,Ma CX.chemotherapy principles of managing stage IV breast cancer in the United States.Chin Clin Oncol,2016,5(3):42-48.
[8]Bai H,Sha G,Cao D,et al.Salvage chemotherapy for patients with recurrent or persistent ovarian clear cell carcinoma:A retrospective study of 164 cases.Medicine(Baltimore),2015,94(27):e1121.
[9]Kuter DJ.Managing thrombocytopenia associated with cancer chemotherapy.Oncology(Williston Park),2015,29(4):282-294.
[10]Vall JW,Wasan H,Johnson P,et al.Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours:a multicentre randomized phaseⅡstudy-The UK ABC-01 Study.Br J Cancer,2009,101(4):621-627.
[11]Elting LS,Rubenstein EB,Martin CG,et a1.Incidence,cost,and outcomes of bleeding and chemotherapy dose modification among solid tumor patients with hemotherapy-induced thrombocytopenia.JClin Oncol,2001,19(4):1137-1146.
[12]白春梅,邹晓阳,赵永强,等.重组人血小板生成素治疗化疗诱导的重度血小板减少的临床研究.中华医学杂志,2004,84(5):397-400.
[13]黄梅,张东华,孙汉英,等.应用重组人血小板生成素临床观察.中国血液流变学杂志,2005,15(2):105-107.
[14]黄乐天,韩峥波,马洁韬,等.重组人血小板生成素预防非小细胞肺癌化疗后血小板减少的观察.疑难病杂志,2016,15(9):892-895.
[15]任天舒,张岩,曲佳鑫,等.重组人血小板生成素与重组人白细胞介素11治疗血小板减少症疗效与安全性的,Meta分析.药物流行病学杂志,2016,25(1):6-10
[16]要国华,覃鹏飞,彭玉娜,等.重组人血小板生成素治疗肺癌患者同步放疗、化疗后血小板减少的临床观察.吉林医学,2013,34(15):2865-2866.
[17]李秋文,叶明,肖文华,等.重组人血小板生成素可预防恶性肿瘤化疗后血小板减少.南方医科大学学报,2012,32(7):1064-1066.DOI:10.3969/issn.1673-4254.2012.07.036.
[18]凌桂琴,陈东波,王保庆.重组人血小板生成素治疗肿瘤化疗后血小板减少的临床观察.临床医药实践,2013,22(11):803-805.
[19]Mcelroy PL,Wei P,Buck K,et al.Romiplostim promotes platelet recovery in a mouse model of multicycle chemotherapy-induced thrombocytopenia.Exp Hematol,2015,43(6):479-487.
[20]温丽玲,余卓丽,梁惠兰,等.英国血小板输注应用指南主要推荐及其启示.中国输血杂志,2018,31(4):440-441.
[2]陈超,郭代红,季晓英,等.重组人血小板生成素的临床应用综合评价.中国药物应用与监测2011 8(1):5-8
[3]胡小秀,罗会芹,陈文菊等.吉西他滨联合柏类治疗晚期非小细胞肺癌临床疗效观察.临床军医杂志,2018,46(4):561-563.
[4]钟辉,闫晓红,崔翠花.重组人血小板生成素预防吉西他滨化疗相关血小板减少症的临床观察.癌症进展,2016,14(10):1010-1012.
[5]Brown T.Pilkington G.Bagust A,et al.Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic nonsmall cell lung cancer:a systematic review and economic evaluation.Health Technol Assess,2013,17(31):1-278.
[6]Lee HS,Park SW.Systemic chemotherapy in advanced pancreatic cancer.Gut Liver,2016,10(3):340-347.
[7]Hernandez-Aya LF,Ma CX.chemotherapy principles of managing stage IV breast cancer in the United States.Chin Clin Oncol,2016,5(3):42-48.
[8]Bai H,Sha G,Cao D,et al.Salvage chemotherapy for patients with recurrent or persistent ovarian clear cell carcinoma:A retrospective study of 164 cases.Medicine(Baltimore),2015,94(27):e1121.
[9]Kuter DJ.Managing thrombocytopenia associated with cancer chemotherapy.Oncology(Williston Park),2015,29(4):282-294.
[10]Vall JW,Wasan H,Johnson P,et al.Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours:a multicentre randomized phaseⅡstudy-The UK ABC-01 Study.Br J Cancer,2009,101(4):621-627.
[11]Elting LS,Rubenstein EB,Martin CG,et a1.Incidence,cost,and outcomes of bleeding and chemotherapy dose modification among solid tumor patients with hemotherapy-induced thrombocytopenia.JClin Oncol,2001,19(4):1137-1146.
[12]白春梅,邹晓阳,赵永强,等.重组人血小板生成素治疗化疗诱导的重度血小板减少的临床研究.中华医学杂志,2004,84(5):397-400.
[13]黄梅,张东华,孙汉英,等.应用重组人血小板生成素临床观察.中国血液流变学杂志,2005,15(2):105-107.
[14]黄乐天,韩峥波,马洁韬,等.重组人血小板生成素预防非小细胞肺癌化疗后血小板减少的观察.疑难病杂志,2016,15(9):892-895.
[15]任天舒,张岩,曲佳鑫,等.重组人血小板生成素与重组人白细胞介素11治疗血小板减少症疗效与安全性的,Meta分析.药物流行病学杂志,2016,25(1):6-10
[16]要国华,覃鹏飞,彭玉娜,等.重组人血小板生成素治疗肺癌患者同步放疗、化疗后血小板减少的临床观察.吉林医学,2013,34(15):2865-2866.
[17]李秋文,叶明,肖文华,等.重组人血小板生成素可预防恶性肿瘤化疗后血小板减少.南方医科大学学报,2012,32(7):1064-1066.DOI:10.3969/issn.1673-4254.2012.07.036.
[18]凌桂琴,陈东波,王保庆.重组人血小板生成素治疗肿瘤化疗后血小板减少的临床观察.临床医药实践,2013,22(11):803-805.
[19]Mcelroy PL,Wei P,Buck K,et al.Romiplostim promotes platelet recovery in a mouse model of multicycle chemotherapy-induced thrombocytopenia.Exp Hematol,2015,43(6):479-487.
[20]温丽玲,余卓丽,梁惠兰,等.英国血小板输注应用指南主要推荐及其启示.中国输血杂志,2018,31(4):440-441.