目的 探討海曲泊帕乙醇胺片聯(lián)合重組人血小板生成素（rhTPO）治療實(shí)體腫瘤治療相關(guān)性血小板減少癥的臨床療效以及其對(duì)患者血清促血小板生成素（TPO）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平的影響。方法 回顧性選擇河南科技大學(xué)第一附屬醫(yī)院2021年9月—2022年6月收治的88例實(shí)體腫瘤治療相關(guān)性血小板減少癥患者作為研究對(duì)象，根據(jù)治療方案不同分為對(duì)照組和試驗(yàn)組，每組44例。試驗(yàn)組給予海曲泊帕乙醇胺片聯(lián)合rhTPO治療，對(duì)照組單用rhTPO治療。比較兩組治療前以及治療第3、7、14天時(shí)血小板計(jì)數(shù)，并比較兩組血小板計(jì)數(shù)恢復(fù)至≥75×10⁹·L^-1、≥100×10⁹·L^-1所需時(shí)間。治療第 14天時(shí)根據(jù)試驗(yàn)對(duì)象血小板計(jì)數(shù)變化情況進(jìn)行療效評(píng)估。治療前后檢測(cè)兩組患者的血清 TPO、IL-6、TNF-α水平。記錄并比較兩組不良反應(yīng)情況。結(jié)果 試驗(yàn)組總有效率為 90.91%，與對(duì)照組（65.91%）相比顯著升高（P＜0.05）。兩組治療前血小板計(jì)數(shù)比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。兩組治療第 3、7、14天時(shí)血小板計(jì)數(shù)均逐漸升高，且均顯著高于治療前（P＜0.05）。治療第3、7、14天時(shí)，試驗(yàn)組血小板計(jì)數(shù)均顯著高于同期對(duì)照組（P＜0.05）。試驗(yàn)組血小板計(jì)數(shù)恢復(fù)至≥75×10⁹·L^-1、≥100×10⁹·L^-1所需時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組血清TPO、IL-6、TNF-α水平均較治療前顯著降低（P＜0.05）；且治療后，試驗(yàn)組血清 TPO、IL-6、TNF-α 水平均顯著低于對(duì)照組（P＜0.05）。試驗(yàn)組不良反應(yīng)發(fā)生率為 15.91%，對(duì)照組為 11.36%，兩組間比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。結(jié)論 海曲泊帕乙醇胺片聯(lián)合 rhTPO治療 SCTRT能有效升高患者體內(nèi)血小板水平，下調(diào)血清TPO、IL-6、TNF-α水平，總體療效確切，且不明顯增加不良反應(yīng)的發(fā)生風(fēng)險(xiǎn)。

Objective To investigate the clinical efficacy of Herombopag Olamine Tablets combined with recombinant human thrombopoietin (rhTPO) in treatment of solid tumor treatment-associated thrombocytopenia (SCTRT) and its effect on serum levels of thrombopoietin (TPO), interleukin-6 (IL-6) and tumor necrosis factor- α (TNF- α). Methods A total of 88 SCTRT patients admitted to The First Affiliated Hospital of Henan University of Science and Technology from September 2021 to June 2022 were selected as the research objects and divided into two groups according to the random number table method, with 44 cases in each group. Patients in the experimental group were treated with Herombopag Olamine Tablets combined with rhTPO, while patients in the control group were treated with rhTPO alone. The platelet counts were compared between the two groups before treatment and on the 3rd, 7th, and 14th day of treatment, and the time required for the platelet counts to rise to ≥ 75 × 10⁹·L^-1 and ≥100 × 10⁹·L^-1 were compared between the two groups. The efficacy was evaluated according to the change of platelet count on the 14th day of treatment. The serum levels of TPO, IL-6 and TNF-α were detected before and after treatment. The adverse reactions of the two groups were recorded and compared. Results The total effective rate of the experimental group was 90.91%, which was significantly higher than that of the control group (65.91%, P＜0.05). There was no significant difference in platelet count between the two groups before treatment (P＞0.05). The platelet counts of the two groups were gradually increased on the 3rd, 7th and 14th day of treatment, and were significantly higher than those before treatment (P＜0.05). On the 3rd, 7th and 14th day of treatment, the platelet count in the experimental group was significantly higher than that in the control group (P＜0.05). The time required for platelet count to rise to ≥ 75 × 10⁹·L^-1 and ≥ 100 × 10⁹·L^-1 in the experimental group was significantly shorter than that in the control group (P＜0.05). After treatment, the serum levels of TPO, IL-6 and TNF- α in the two groups were significantly decreased compared with those before treatment (P＜0.05). After treatment, the serum levels of TPO, IL-6 and TNF-α in the experimental group were significantly lower than those in the control group (P＜0.05). The incidence of adverse reactions was 15.91% in the experimental group and 11.36% in the control group, and there was no significant difference between the two groups (P＞0.05). Conclusion Herombopag Olamine Tablets combined with rhTPO in treatment of SCTRT can effectively increase the level of platelet in patients with SCTRT, and down-regulate the levels of serum TPO, IL-6, TNF-α. The overall efficacy is exact, and does not increase the risk of adverse reactions.

R973