海曲泊帕治疗实体瘤化疗后血小板Ⅲ、Ⅳ度患者的临床疗效分析

Clinical efficacy analysis of herombopag in the treatment of grade III and IV thrombocytopenia in patients with solid tumors after chemotherapy

摘要:

目的 探讨海曲泊帕应用于实体瘤化疗后血小板Ⅲ、Ⅳ度患者的临床疗效。方法 回顾性分析2022年6月—2023年6月包头市肿瘤医院收治的98例实体瘤化疗后血小板Ⅲ、Ⅳ度患者的临床资料，根据不同治疗方案分为对照组和观察组，分别为48和50例。对照组皮下注射重组人血小板生成素注射液，观察组在对照组基础上口服海曲泊帕。治疗4周后。比较两组患者血小板计数、血小板平均体积、血小板分布宽度、血小板生成素（TPO）、信号转导和转录激活因子3（STAT3）、丝裂原活化蛋白激酶（MAPK）、CD3⁺、CD4⁺、CD4⁺/CD8⁺、出血风险分级及不良反应率。结果 观察组治疗前后血小板计数、血小板平均体积和血小板分布宽度的差值均高于对照组（P <0.05）。观察组治疗前后TPO、STAT3、MAPK的差值均高于对照组（P <0.05）。观察组治疗前后CD4⁺/CD8⁺的差值高于对照组（P <0.05）。两组治疗前后CD4⁺、CD8⁺的差值比较，差异均无统计学意义（P >0.05）。观察组出血风险分级低于对照组（P <0.05）。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 海曲泊帕应用于实体瘤化疗后血小板Ⅲ、Ⅳ度患者的治疗中，有助于升高血小板水平，安全性良好。

Abstract:

Objective To analyze the clinical efficacy of herombopag in the treatment of grade III and IV thrombocytopenia following chemotherapy for solid tumors.Methods Retrospective analysis of the medical records of 98 patients with grade III and IV thrombocytopenia following chemotherapy for solid tumors admitted to Baotou Cancer Hospital from June 2022 to June 2023. According to the treatment regimen, they were divided into a control group (48 cases) and an observation group (50 cases). The control group received subcutaneous injections of recombinant human thrombopoietin, while the observation group was additionally treated with oral herombopag olamine tablets. After 4 weeks of treatment, the platelet count, mean platelet volume, platelet distribution width, levels of thrombopoietin (TPO), signal transducer and activator of transcription 3 (STAT3), and mitogen activated protein kinase (MAPK), frequencies of CD3⁺ and CD4⁺ T cells, the CD4⁺/CD8⁺ T cells ratio, the bleeding risk grade, and the incidence of adverse reactions were compared between two groups of patients.Results The differences of platelet count, mean platelet volume, and platelet distribution width before and after the treatment in the observation group were higher than those in the control group (P < 0.05), and the differences of the levels of TPO, STAT3, and MAPK before and after the treatment in the observation group were higher than those in the control group (P < 0.05). The difference of the CD4⁺/CD8⁺ T cells ratio before and after the treatment in the observation group was higher than that in the control group (P < 0.05). The differences of the frequencies of CD3⁺ and CD4⁺ T cells before and after the treatment were not different between the two groups (P > 0.05). The bleeding risk grade in the observation group was lower than that in the control group (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05).Conclusions The use of herombopag in the treatment of patients with grade III and IV thrombocytopenia following chemotherapy for solid tumors facilitates the increase of the platelet count and has a good safety profile.