关键词: 肝硬化, 脾功能亢进症, 血小板减少症, 阿伐曲泊帕, 部分脾动脉栓塞术, 治疗

Abstract: Objective The purpose of this pilot study was investigate transit oral avatrombopag therapy as a bridge to partial splenic artery embolization (PSAE) in treatment of patients with liver cirrhosis (LC) and hypersplenism with thrombocytopenia. Methods A total of 116 patients with hepatitis B-induced LC with splenomegaly and thrombocytopenia were encountered in our hospital between January 2022 and January 2024, and were randomly assigned to receive conventional supporting treatment in 58 cases as control, or receive oral avatrombopag therapy for 5 days, then the PSAE was performed in another 58 cases in observation group. Results At presentation, peripheral blood platelet, white blood cell and red blood cell counts in the observation were (46.5±7.6)×10⁹/L, (3.8±0.7)×10⁹/L and (3.2±0.7×10¹²/L), all not significantly different as compared to [(46.9±8.1)×10⁹/L, (3.6±0.6)×10⁹/L and (3.0±0.4)×10¹²/L, P>0.05] in the control, while five days after treatment, the platelet count was (127.8±20.9)×10⁹/L, significantly higher than [(47.1±8.6)×10⁹/L, P<0.05] in the control; the PSAE was successfully completed in the 58 patients in the observation group after platelet counts elevated; three months after PSAE, peripheral blood platelet and white blood cell counts returned to normal, and serum albumin level was(35.0±3.8)g/L, much higher than [(32.0±4.4)g/L, P<0.05] at admission in the observation group; a few patients had gastrointestinal symptoms, dizziness, fatigue and rash during taking avatrombopag and disappeared by discontinuation. Conclusion Transit oral avatrombopag could elevate platelet counts rapidly, which might guarantee interventional operation going smoothly.

Key words: Liver cirrhosis, Hypersplenism, Thrombocytopenia, Avatrombopag, Partial splenic artery embolization, Therapy