Department of Critical Care Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China.
Department of Pulmonary and Critical Care Medicine, Hainan General Hospital, Haikou, China.
Int J Clin Pract. 2022 Dec 30;2022:2124019. doi: 10.1155/2022/2124019. eCollection 2022.
Previous studies suggest that sepsis remains a common critical illness with a global incidence of 31.5 million. The aim of this study was to evaluate the comparative therapeutic value of recombinant human thrombopoietin (rhTPO) in treating sepsis patients with thrombocytopenia. We conducted a comprehensive electronic search of PubMed, EMBASE, the Cochrane Library, and CNKI from its inception through December 31, 2021. Thirteen randomized controlled trials (RCTs) involving 963 patients were included. Network meta-analyses showed that rhTPO 300 U/kg/day and rhTPO 15000 U/day significantly increased the platelet (PLT) levels on the 7 day and decreased the requirement of transfusion of red blood cells (RBCs), plasma, and PLT compared with IVIG and NAT. SUCRA showed that rhTPO 300 U/kg/day ranked first in terms of 28-day mortality (85.5%) and transfusion, including RBC (88.7%), plasma (89.6%), and PLT (95.2%), while rhTPO 15000 U/day ranked first for the length of the intensive care unit (ICU) stay (95.9%) and PLT level at day 7 (91.6%). rhTPO 300 U/kg/day may be the optimal dose to reduce 28-day mortality and transfusion requirements. However, rhTPO 15000 U/day may be the optimal dose for shortening the ICU stay and increasing the PLT level on the 7th day. However, additional studies to further validate our findings are needed.
先前的研究表明，脓毒症仍然是一种常见的危重症，全球发病率为 3150 万例。本研究旨在评估重组人血小板生成素（rhTPO）治疗脓毒症血小板减少症患者的比较治疗价值。我们对 PubMed、EMBASE、Cochrane 图书馆和中国知网（CNKI）进行了全面的电子检索，检索时间从建库至 2021 年 12 月 31 日。共纳入了 13 项随机对照试验（RCT），涉及 963 例患者。网络荟萃分析显示，rhTPO 300 U/kg/天和 rhTPO 15000 U/天与 IVIG 和 NAT 相比，可显著提高第 7 天的血小板（PLT）水平，并减少红细胞（RBC）、血浆和 PLT 的输血需求。SUCRA 显示，rhTPO 300 U/kg/天在 28 天死亡率（85.5%）和输血方面排名第一，包括 RBC（88.7%）、血浆（89.6%）和 PLT（95.2%），而 rhTPO 15000 U/天在 ICU 住院时间（95.9%）和第 7 天 PLT 水平（91.6%）方面排名第一。rhTPO 300 U/kg/天可能是降低 28 天死亡率和输血需求的最佳剂量。然而，rhTPO 15000 U/天可能是缩短 ICU 住院时间和提高第 7 天 PLT 水平的最佳剂量。然而，需要进一步的研究来进一步验证我们的发现。
