重组人血小板生成素促进异基因造血干细胞移植后血小板恢复的Meta分析

目的:系统评价重组人血小板生成素促进异基因造血干细胞移植后血小板恢复的有效性。方法:计算机检索PubMed、Embase、Cocharne图书馆、Web of Science、CNKI、VIP、CBM、万方数据库等数据库，查找重组人血小板生成素促进异基因造血干细胞移植后血小板恢复的随机对照试验（RCT）。按照Cochrane手册5.1.0 RCT的质量评价标准对纳入研究的方法学质量进行评价，并使用RevMan 5.2软件进行Meta分析。结果:共纳入4个RCTs，包括332例患者。Meta分析结果显示:与空白组比较，重组人血小板生成素在第4天［MD=-2.67，95%CI（-4.97，-0.37），P=0.02］和第7天给药［MD=-3.97，95%CI（-5.35，-2.59），P＜0.00001］可缩短血小板恢复至>20×109/L时间，加快血小板恢复>50×109/L的时间［MD=-6.5，95%CI（－8.53，－4.48），P＜0.00001］，但在血小板输注数量和粒细胞植入时间等方面，两组无差别。结论:现有证据表明，与空白对照比较，重组人血小板生成素对异基因造血干细胞移植后促进血小板恢复有一定积极作用，其有效性和安全性尚需进一步开展高质量、大样本的随机对照试验验证。

Recombinant human thrombopoietin improves platelet recovery after allogeneic hematopoietic stem cell transplantation :A Meta-analysis

Objective:To assess the effects of recombinant humanized thrombopoietin(rhTPO) treatment in patients receiving allo-HSCT．Methods:The electronic databases such as PubMed,EMbase,Cochrane Library,Web of Science，CNKI,VIP,CBM，WanFang Data were searched to collect RCTs of recombinant human thrombopoietin(rhTPO) in patients receiving allo-HSCT.The methodology quality of the included studies was evaluated in accordance with RCTs quality evaluation standard of the Cochrane Handbook 5.1.0,and meta-analyses were performed by using RevMan 5.2 software.Results:Four RCTs involving 332 participants were included.The results of meta-analysis showed that compared with the control group,rhTPO can expedite the time of platelet recovery to >20×109/L starting from day +4［MD=-2.67，95%CI（-4.97，-0.37），P=0.02］and day +7［MD=-3.97，95%CI（-5.35，-2.59），P＜0.00001］,shorten the time of platelet elevated to>50×109/L［MD=-6.5，95%CI（－8.53，－4.48），P＜0.00001］.But there was no difference between the two groups in the unites platelets transfused and granulocyte engraftment time.Conclusion:According to the current evidence,compared with the control group，recombinant human thrombopoietin(rhTPO) improves platelet recovery after receiving allo-HSCT.However，its effect and safety still needs to be further verified by more large sample and high quality RCTs．