重组人血小板生成素治疗脓毒症相关性血小板减少症临床疗效的Meta分析

目的 系统评价重组人血小板生成素(rhTPO)治疗脓毒症相关性血小板减少症(SAT)的临床疗效. 方法 计算机检索PubMed数据库、EMbase数据库、Cochrane library数据库、中国知网数据库、万方数据库、维普数据库自建库至2019年8月15日间关于rhTPO治疗SAT的相关文献.由3名研究人员独立进行...

Clinical efficacy of recombinant human thrombopoietin for treating sepsis-associated thrombocytopenia:a meta-analysis

Objective To systematically evaluate the clinical efficacy of recombinant human thrombopoietin(rhTPO)in the treatment of sepsis-associated thrombocytopenia(SAT).Methods Clinical trials about rhTPO for treating patients with SAT were retrieved from the PubMed,Embase,Cochrane library,CNKI,Wanfang and VIP databases published up to August 15,2019.Three reviewers independently screened articles,extracted data and evaluated methodological quality.Then meta-analysis was conducted using the Review Manager 5.3 software.Results Nine articles with 653 SAT patients were enrolled in this study.Meta-analysis showed that as compared with the control group,the 28-day mortality was not significantly lower[relative risk=0.83,95%confidence interval(CI)(0.62,1.10),Z=1.29,P=0.20],while the length of ICU stay was much shorter[standard mean difference(SMD)=-0.49,95%CI(-0.85,-0.13),Z=2.65,P=0.008],and the peripheral blood platelet count on 7 d after treatment was much better[SMD=2.16,95%CI(1.13,3.19),Z=4.11,P<0.0001],and the transfusion volumes of platelet[SMD=-1.29,95%CI(-1.65,-0.93),Z=7.09,P<0.00001],plasma[SMD=-2.08,95%CI(-3.53,-0.64),Z=2.82,P=0.005]and red blood cell[SMD=-1.33,95%CI(-2.22,-0.44),Z=2.94,P=0.003]were much lower in the experimental group.Conclusion rhTPO can shorten length of ICU stay,improve platelet counts in peripheral blood,and reduce transfusion volumes of platelet,plasma and red blood cell,but it cannot ameliorate 28-day mortality in patients with SAT.