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

doi:10.3877/cma.j.issn.1674-6880.2021.01.010

Abstract

Abstract:

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 < 0.000 1], and the transfusion volumes of platelet [SMD=-1.29, 95%CI (-1.65, -0.93), Z=7.09, P < 0.000 01], 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.

Key words: Recombinant human thrombopoietin, Sepsis, Thrombocytopenia, Meta-analysis

Guangyong Jin, Wei Hu, Yongke Zheng, Bingwei Liu, Rui Ye, Yiwei Li, Shaosong Xi. Clinical efficacy of recombinant human thrombopoietin for treating sepsis-associated thrombocytopenia: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2021, 14(01): 49-55.

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Figures/Tables 8

References 29

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纳入文献	研究设计	样本量（例）		平均年龄（岁，±s或均数）		干预措施
纳入文献	研究设计	试验组	对照组	试验组	对照组	试验组	对照组
Wu等^[9]	非RCT	38	34	53.16	49.29	rhTPO 15 000 U/d	空白对照
吴骎^[10]	多中心、非RCT	64	61	59.09 ± 16.52	61.55 ± 10.28	rhTPO 15 000 U/d	空白对照
于生才等^[11]	非RCT	39	57	56.34 ± 5.19	55.17 ± 6.04	rhTPO 300 U·kg^-1· d^-1	空白对照
张小亚等^[12]	非RCT	34	42	54.50 ± 19.53	53.65 ± 15.52	rhTPO 15 000 U/d	空白对照
李艳等^[13]	RCT	28	20	53.49 ± 17.41		rhTPO 300 U·kg^-1· d^-1	空白对照
杨蕙文等^[14]	RCT	30	30	45.20 ± 12.70		rhTPO 300 U·kg^-1· d^-1	等渗NaCl溶液
漆红等^[15]	RCT	30	30	50.30 ± 26.20	50.90 ± 25.70	rhTPO 15 000 U/d	空白对照
章渭方等^[16]	RCT	35	31	56.00 ± 9.00	54.00 ± 8.00	rhTPO 300 U·kg^-1· d^-1	空白对照
颜杨杨^[17]	非RCT	25	25	52.60 ± 2.70	53.5 ± 2.4	rhTPO 15 000 U/d	空白对照

纳入文献	研究设计	样本量（例）		平均年龄（岁，±s或均数）		干预措施
纳入文献	研究设计	试验组	对照组	试验组	对照组	试验组	对照组
Wu等^[9]	非RCT	38	34	53.16	49.29	rhTPO 15 000 U/d	空白对照
吴骎^[10]	多中心、非RCT	64	61	59.09 ± 16.52	61.55 ± 10.28	rhTPO 15 000 U/d	空白对照
于生才等^[11]	非RCT	39	57	56.34 ± 5.19	55.17 ± 6.04	rhTPO 300 U·kg^-1· d^-1	空白对照
张小亚等^[12]	非RCT	34	42	54.50 ± 19.53	53.65 ± 15.52	rhTPO 15 000 U/d	空白对照
李艳等^[13]	RCT	28	20	53.49 ± 17.41		rhTPO 300 U·kg^-1· d^-1	空白对照
杨蕙文等^[14]	RCT	30	30	45.20 ± 12.70		rhTPO 300 U·kg^-1· d^-1	等渗NaCl溶液
漆红等^[15]	RCT	30	30	50.30 ± 26.20	50.90 ± 25.70	rhTPO 15 000 U/d	空白对照
章渭方等^[16]	RCT	35	31	56.00 ± 9.00	54.00 ± 8.00	rhTPO 300 U·kg^-1· d^-1	空白对照
颜杨杨^[17]	非RCT	25	25	52.60 ± 2.70	53.5 ± 2.4	rhTPO 15 000 U/d	空白对照

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