中南药学

目的 探讨阿伐曲泊帕治疗慢性肝病相关性血小板减少症(CLDT)的疗效及其影响因素。方法 回顾性纳入2023年1月至2024年12月在安徽医科大学第一附属医院接受阿伐曲泊帕治疗的CLDT患者的临床数据，记录并分析血小板计数(PLT)变化，采用多因素Logistic回归分析影响阿伐曲泊帕疗效的主要因素。结果 123例患者应用阿伐曲泊帕治疗后，总体有效率为57.7%(71/123)，中位起效时间为6(4,8)d，中位达峰时间为13(11,18)d,PLT峰值为186.00(133.25,282.50)×10⁹/L,PLT增幅为102.00(60.00,203.00)×10⁹/L；阿伐曲泊帕显著提升了患者的PLT(P<0.01)。单因素分析结果显示，年龄≥65岁和血小板基线水平是影响疗效的潜在因素(P<0.1)。Logistic回归分析结果显示，年龄是影响阿伐曲泊帕疗效的独立危险因素(OR=2.173,95%CI:1.015～4.652,P=0.046)。且123例患者在住院期间未观察到与药物相关的不良反应。结论 阿伐曲泊帕能有效提升CLDT患者的PLT，且治疗过程中安全性良好，但其总体临床有效率偏低。多因素分析表明年龄≥65岁是疗效不佳的独立危险因素，在临床实践中应加强对高龄患者的监测与个体化治疗。

Objective To determine the efficacy of avatrombopag in treating chronic liver diseaseassociated thrombocytopenia(CLDT) and identify factors influencing its therapeutic effect. Methods Clinical data of patients with CLDT who were treated with avatrombopag at the First Affiliated Hospital of Anhui Medical University from January 2023 to December 2024 were retrospectively collected. Changes in platelet count were recorded and analyzed, and multivariate Logistic regression was used to identify the main factors influencing the efficacy of avatrombopag. Results Among 123 patients treated with avatrombopag, the overall response rate was 57.7%(71/123). The median time to response was 6(4, 8) days, and the median time to peak platelet count was 13(11, 18) days. The peak platelet count was 186.00(133.25, 282.50)×10⁹/L, with an increase of 102.00(60.00, 203.00)×10⁹/L. Avatrombopag significantly increased PLT in patients(P < 0.01). Univariate analysis showed that age ≥ 65 years and baseline platelet level were potential factors affecting efficacy(P < 0.1). Logistic regression analysis showed that age was an independent risk factor affecting the efficacy of avatrombopag(OR = 2.173, 95%CI: 1.015 ～ 4.652, P =0.046). No drug-related adverse reactions were observed among the 123 patients during hospitalization. Conclusion Avatrombopag effectively increases PLT in patients with CLDT with a favorable safety profile; however, its overall clinical response rate remains relatively low. Multivariate analysis indicates that age ≥ 65 years is an independent risk factor for poor efficacy. In clinical practice, closer monitoring of treatment response and individualized therapy should be emphasized for elderly patients.