Montaner J S, Le T, Fanning M, Gelmon K, Tsoukas C, Falutz J, O'Shaughnessy M, Wainberg M A, Ruedy J
Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
J Acquir Immune Defic Syndr (1988). 1990;3(6):565-70.
Seventy-four HIV-infected homosexual males belonging to CDC groups IIB, III, and IVC2 were treated with increasing doses of zidovudine within the Multicentre Canadian AZT Trial. Following a 3 week observation period, consenting volunteers received 600 mg/day for 18 weeks, 900 mg/day for 9 weeks, and 1,200 mg/day for 9 weeks. This was followed by a 6 week washout period after which zidovudine was restarted at 1,200 mg/day for 18 weeks. Patients were followed for a total of 63 weeks. Every 3 weeks they underwent a full clinical and laboratory assessment. For the purpose of this analysis, subjects were divided according to the mean initial platelet value (greater than or equal to 150,000 or less than 150,000/L) into normals (n = 57) and thrombocytopenics (n = 12), respectively. Analysis of variance was used to compare the mean platelet values at each zidovudine dose. All comparisons were made against baseline values. Zidovudine increased platelet counts in normal and thrombocytopenic subjects. The magnitude of this effect varied depending on the baseline platelet count. Among normals, the platelet count increased from 241,000 +/- 45,000/L at baseline to 261,000 +/- 51,000/L (p less than 0.01). while receiving 600 mg/day of zidovudine. This effect was self-limited, reaching a peak by week 3. The platelet count decreased to baseline values despite increasing the dose of zidovudine to 900 or 1,200 mg/day. The platelet count further decreased to 218,000 +/- 43,000/L during the washout phase (washout vs. 1,200 mg, p less than 0.01).2+ not found to be dose related. The platelet count decreased to 101,000 +/- 34,000/L during the washout phase (washout vs. 1,200 mg/day, p less than 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)
在加拿大多中心齐多夫定试验中，74名属于疾病控制与预防中心（CDC）IIB、III和IVC2组的HIV感染同性恋男性接受了递增剂量的齐多夫定治疗。在为期3周的观察期后，同意参与的志愿者接受600毫克/天的治疗，持续18周；然后900毫克/天，持续9周；再然后1200毫克/天，持续9周。之后是6周的洗脱期，在此之后，齐多夫定以1200毫克/天的剂量重新开始使用，持续18周。患者总共被随访63周。每3周他们接受一次全面的临床和实验室评估。为了本次分析的目的，受试者根据平均初始血小板值（大于或等于150,000或小于150,000/升）分别分为正常组（n = 57）和血小板减少组（n = 12）。采用方差分析来比较每个齐多夫定剂量下的平均血小板值。所有比较均与基线值进行。齐多夫定使正常和血小板减少受试者的血小板计数增加。这种效应的程度因基线血小板计数而异。在正常组中，接受600毫克/天齐多夫定治疗时，血小板计数从基线时的241,000±45,000/升增加到261,000±51,000/升（p＜0.01）。这种效应是自限性的，在第3周达到峰值。尽管将齐多夫定剂量增加到900或1200毫克/天，血小板计数仍降至基线值。在洗脱期，血小板计数进一步降至218,000±43,000/升（洗脱期与1200毫克相比，p＜0.01）。未发现2+与剂量相关。在洗脱期，血小板计数降至101,000±34,000/升（洗脱期与1200毫克/天相比，p＜0.07）。（摘要截断于250字）
