Wu Qin, Ren Jianan, Wu Xiuwen, Wang Gefei, Gu Guosheng, Liu Song, Wu Yin, Hu Dong, Zhao Yunzhao, Li Jieshou
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
J Crit Care. 2014 Jun;29(3):362-6. doi: 10.1016/j.jcrc.2013.11.023. Epub 2013 Dec 12.
Thrombocytopenia is prevalent in patients with severe sepsis, and it is associated with mortalities. Effectively adjunctive treatment might be needed to reverse low platelet counts (PCs). With a growing understanding of thrombocytopenia, recombinant human thrombopoietin (rhTPO) is considered a promising beneficial drug. The present study was dedicated to evaluate the efficiency of rhTPO in improving PCs in patients with severe sepsis.
We performed a prospective study in patients with severe sepsis between March 2012 and February 2013. All enrolled patients were divided into rhTPO group and control group, depending on whether rhTPO was prescribed or not. Platelet counts and other parameters were measured initially and in the following 15 days.
Totally, 72 patients (38 in the rhTPO group and 34 in the control group) were included. All enrolled parameters exhibited no significant differences between groups at the baseline. Platelet counts showed a significant increase over time in both groups. Faster improvement of PCs in the rhTPO group was observed with a significant difference. Less platelet transfusion occurred in patients who received rhTPO in our study, as well. No drug-related adverse event during the rhTPO therapy was recorded.
The use of rhTPO in combination with conventional medical therapies could significantly improve the PCs in patients with severe sepsis and thrombocytopenia and effectively reduce the platelet transfusion possibility.
血小板减少症在严重脓毒症患者中很常见,且与死亡率相关。可能需要有效的辅助治疗来逆转低血小板计数(PCs)。随着对血小板减少症认识的不断加深,重组人血小板生成素(rhTPO)被认为是一种有前景的有益药物。本研究致力于评估rhTPO对改善严重脓毒症患者血小板计数的效果。
我们在2012年3月至2013年2月期间对严重脓毒症患者进行了一项前瞻性研究。根据是否使用rhTPO,将所有纳入的患者分为rhTPO组和对照组。在初始阶段及随后的15天内测量血小板计数和其他参数。
总共纳入72例患者(rhTPO组38例,对照组34例)。所有纳入参数在基线时两组间无显著差异。两组血小板计数均随时间显著增加。观察到rhTPO组血小板计数改善更快,差异有统计学意义。在我们的研究中,接受rhTPO治疗的患者血小板输注也较少。rhTPO治疗期间未记录到与药物相关的不良事件。
rhTPO与传统药物治疗联合使用可显著改善严重脓毒症合并血小板减少症患者的血小板计数,并有效降低血小板输注的可能性。