Efficacy of avatrombopag on chronic liver disease thrombocytopenia in patients undergoing invasive surgery
Objective To observe the therapeutic effect of avatrombopag in patients with chronic liver disease(CLD)-related severe thrombocytopenia(TCP)planning to undergo invasive surgery.Methods 80 CLD-related severe TCP patients who were scheduled to undergo invasive surgery in our hospital were selected and divided into observation group and control group according to random number table method,with 40 cases in each group.Five to eight days before the planned invasive surgery,the control group was given recombinant human thrombopoietin(rhTPO)treatment,while the observation group was given avatrombopag for 5 days.The changes in platelet count(PLT),the proportion of patients who were rescued without platelet transfusion or bleeding from any cause within 7 days after surgery,liver function[alanine aminotransferase(ALT)and aspartate transaminase(AST)],total bilirubin(TBiL)and albumin(ALB),portal vein thrombosis(PVT)formation and the incidence of adverse reactions were compared.Results Before treatment,there was no significant difference in the levels of ALT,AST,TBiL and ALB between the 2 groups.On the 7th day after operation,the levels of ALT,AST and TBiL in both groups were increased compared with those before treatment,and the ALB was decreased(P＜0.05).However,there was no significant difference in the 4 biochemical indexes between the 2 groups on the 7th days after operation.After treatment,the proportion of PLT elevation in the observation group meeting the requirements for invasive surgery(PLT≥50×109·L-1)was(97.50%)higher than that in the control group(80.00%)(P＜0.05).With the prolongation of medication time,the PLT in the observation group began to increase on the 4th day after medication,reached a peak on the 13th day,and decreased to the baseline level after the 35th day.The PLT in the control group began to increase on the 6th day after administration,reached a peak on the 14th day,and decreased to the baseline level after the 21st day.The PLT of the observation group was higher than that of the control group on the 4th,6th,8th,10th,12th,13th,14th,and 21st days after treatment(P＜0.05).The proportion of patients in the observation group who did not need platelet transfusion or bleeding for any reason within 7 days after surgery was(87.18%)higher than that in the control group 62.50%,P＜0.05.There was no PVT formation in either group.There was no significant difference in the incidence of adverse drug reactions between the 2 groups(P＞0.05).Conclusion Avatrombopag can significantly increase platelet levels and reduce platelet transfusion requirements before invasive surgery in patients with CLD-related severe TCP,without increasing the risk of PVT formation and adverse reactions,and the patients are well tolerated.
avatrombopagrecombinant human thrombopoietin(rhTPO)invasive surgerychronic liver diseasethrombocytopenia
万方数据
维普
