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目的:探讨重组人血小板生成素（rhTPO）对脓毒症伴血小板减少症患者的作用。方法:应用前瞻性、随机对照研究方法，选择2019年8月至2020年10月郑州大学第一附属医院重症医学科收治的脓毒症伴血小板减少症患者100例为研究对象，依据随机数字表法分为应用rhTPO组（TPO组）和常规治疗组（对照组），每组50例；两组均按照脓毒症Sepsis-3推荐方法给予综合治疗，TPO组在此基础上给予rhTPO 15 000 U皮下注射，每日1次，连用7 d。记录两组患者一般资料、急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）、治疗前及治疗第1、3、5、7天血小板计数（PLT）、凝血功能〔凝血酶原时间（PT）、凝血酶原活动度（PTA）〕、心肌酶〔肌钙蛋白（Tn）、肌酸激酶（CK）〕、肝肾功能〔天冬氨酸转氨酶（AST）、总胆红素（TBil）、肌酐（Cr）〕及炎症指标〔降钙素原（PCT）、C-反应蛋白（CRP）〕，并记录血液成分输注量、机械通气时间、重症监护病房（ICU）住院时间、总住院时间、住院总费用及28 d结局；根据PLT是否小于50×10n 9/L将TPO组患者分为TPO A组（PLT≥50×10n 9/L，16例）和TPO B组（PLT0.05）。② TPO组在治疗第5天、第7天PLT均明显高于同期对照组（×10n 9/L：第5天63.94±44.01比49.85±29.26，第7天125.85±112.31比76.81±50.87，均n P0.05）。③ TPO组血小板输注量明显少于对照组〔U：0（0，0）比0（0，2.00），n P＝0.001〕。④ TPO组与对照组的机械通气时间、ICU住院时间、总住院时间、住院总费用、28 d病死率比较差异均无统计学意义（均n P>0.05）。TPO A组机械通气时间、ICU住院时间、总住院时间均长于TPO B组，但两组差异无统计学意义〔机械通气时间（h）：131.00（0，311.00）比50.00（0，192.00），ICU住院时间（d）：14.44±8.57比11.73±9.24，总住院时间（d）：15.00（6.00，23.50）比18.00（8.00，31.00），均n P>0.05〕；TPO A组PLT升高绝对值高于TPO B组，但两组差异无统计学意义〔×10n 9/L：65.00（16.50，131.50）比36.00（18.00，130.00），n P>0.05〕。n 结论:rhTPO可升高脓毒症血小板减少症患者的PLT，从而减少血小板输注量，但不能缩短患者ICU住院时间和总住院时间，不能减少住院费用，不能降低28 d病死率。“,”Objective:To investigate the effect of recombinant human thrombogenin (rhTPO) on sepsis-associated thrombocytopenia.Methods:A prospective randomized controlled study was conducted. One hundred patients with sepsis-associated thrombocytopenia admitted to the department of critical care medicine of the First Affiliated Hospital of Zhengzhou University from August 2019 to October 2020 were enrolled. The enrolled patients were divided into rhTPO-using group (TPO group) and routine group (control group) by random number table method, with 50 cases in each group. Both groups were treated according to the guideline of Sepsis-3. In addition, TPO group received rhTPO 15 000 U, once daily for 7 days. Geneal information and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) were recorded. The levels of platelet count (PLT), blood coagulation function [prothrombin time (PT) and prothrombin activity (PTA)], myocardial enzyme indexes [troponin (Tn) and creatine kinase (CK)], liver and kidney function [aspartate aminotransferase (AST), total bilirubin (TBil) and creatinine (Cr)] and inflammatory biomarkers [procalcitonin (PCT) and C-reactive protein (CRP)] were recorded before treatment and 1, 3, 5 and 7 days after treatment. The infusion volume of blood components, duration of mechanical ventilation, length of stay in ICU, total length of hospitalization, total cost of hospitalization and 28-day outcome were recorded. According to whether the PLT was lower than 50×10n 9/L, the patients in TPO group were divided into the TPO A group (PLT≥50×10n 9/L, 16 cases) and TPO B group (PLT 0.05). ② The PLT levels of the TPO group were significantly higher than those of the control group on the 5th and 7th day after treatment (×10 n 9/L: day 5, 63.94±44.01 vs. 49.85±29.26, day 7, 125.85±112.31 vs. 76.81±50.87, both n P 0.05). ③ The amount of platelet transfusion in the TPO group was lower than that in the control group [U: 0 (0, 0) vs 0 (0, 2.00), n P = 0.001]. ④ There were no statistically significant differences in mechanical ventilation time, length of stay in ICU, total length of hospitalization, total cost of hospitalization or 28-day outcome between TPO and control groups (all n P > 0.05). The mechanical ventilation time, ICU stay time and total hospitalization time of TPO A group were longer than those in TPO B group, but the differences were not statistically significant [mechanical ventilation time (hours): 131.00 (0, 311.00) vs. 50.00 (0, 192.00), ICU stay time (days): 14.44±8.57 vs. 11.73±9.24, total hospitalization time (days): 15.00 (6.00, 23.50) vs. 18.00 (8.00, 31.00), all n P > 0.05]. The absolute value of PLT increase in TPO A group was higher than that of TPO B group, but the difference was not statistically significant [×10 n 9/L: 65.00 (16.50, 131.50) vs. 36.00 (18.00, 130.00), n P > 0.05].n Conclusion:RhTPO can significantly increase the PLT of patients with sepsis-related thrombocytopenia, thereby reduce the amount of platelet transfusion, but it cannot shorten the length of ICU stay time and total hospitalization time, and it cannot reduce 28-day mortality.