【摘要】 目的 评估阿伐曲泊帕在肝移植围手术期重度血小板减少症中的临床疗效，并与重组人血小板生成素（recombinant human thrombopoietin,rh TPO）及输注血小板进行比较。方法 回顾性分析2019年5月至2023年12月期间华中科技大学同济医学院附属同济医院88例肝移植术后出现重度血小板减少症患者的临床资料，根据治疗方法分为阿伐曲泊帕组（n=33）、rh TPO组（n=27）和输注血小板组（n=28）。主要评价指标为治疗后第7天血小板计数>50×10~9/L或升高>20×10~9/L的有效率。结果 阿伐曲泊帕组的7 d有效率为96.97%，显著高于rh TPO组的70.37%(P=0.008）和输注血小板组的60.71%(P<0.001）。治疗后第3天血小板计数即显著升高，第5天大多可达治疗有效水平。3组基线特征无统计学差异。结论 阿伐曲泊帕在治疗肝移植围手术期重度血小板减少症中疗效显著，优于rh TPO和输注血小板，且起效快，安全性良好，具有重要临床价值。需进一步多中心随机对照研究验证。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of avatrombopag in the treatment of severe thrombocytopenia during the perioperative period of liver transplantation,and to compare it with recombinant human thrombopoietin (rh TPO) and platelet transfusion.Methods A retrospective analysis was conducted on 88 patients who developed severe thrombocytopenia after liver transplantation between May 2019 and December 2023 in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology.Patients were divided into three groups based on treatment:avatrombopag group (n=33),rh TPO group (n=27),and platelet transfusion group(n=28).The primary endpoint was the effective rate,which was defined as platelet count>50×10~9/L or an increase>20×10~9/L on day 7 post-treatment.Results The avatrombopag group achieved a significantly higher effective rate of 96.97%on day 7 compared to the rh TPO group (70.37%,P=0.008) and platelet transfusion group (60.71%,P<0.001).Platelet counts in the avatrombopag group showed significant improvement from day 3 and reached effective levels by day 5 in most patients.Baseline characteristics were comparable across groups.Conclusion Avatrombopag demonstrates superior efficacy over rh TPO and platelet transfusion in managing severe perioperative thrombocytopenia following liver transplantation,with rapid onset and favorable safety profile.Further multicenter randomized controlled trials are warranted.更多还原