重组人白细胞介素-11预防急性白血病化疗后血小板减少疗效观察
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摘要
目的探讨重组人白细胞介素-11 (rhIL-11)预防急性白血病化疗后血小板减少的临床效果。方法选择2016年5月至2017年5月宝鸡市人民医院收治的急性白血病患者共56例,按照随机数表法分为观察组和对照组,每组28例。对照组采用常规化疗,观察组在此基础上采用rhIL-11治疗,治疗时间28 d。治疗后比较两组患者的血小板计数最低值、血小板恢复至100×109/L的时间、平均血小板输注量、出血情况和不良反应发生率。结果观察组和对照组血小板最低值[(8.5±1.6)×109/L vs (8.4±1.9)×109/L]比较,差异无统计学意义(P>0.05);观察组患者血小板最高值为(167.4±25.3)×109/L,明显高于对照组的(91.8±20.6)×109/L,差异有统计学意义(P<0.05);观察组患者的血小板恢复时间为(12.1±5.4) d,明显短于对照组的(16.7±6.1) d,差异有统计学意义(P<0.05);观察组患者血小板输注量为(7.0±3.5) U,明显低于对照组(10.4±3.9) U,差异有统计学意义(P<0.05);观察组患者中有6例(21.4%)出现出血状况,包括3例皮肤瘀点瘀斑,2例黏膜出血和1例内脏出血,对照组有17例(60.7%)出现出血状况,包括9例皮肤瘀点瘀斑,6例黏膜出血和2例内脏出血,两组比较差异有统计学意义(P<0.05)。结论 rhIL-11预防急性白血病化疗后血小板减少效果确切,可以有效促进血小板生成,值得临床推广应用。
Objective To investigate the clinical effect of recombinant human interleukin-11(rhIL-11) in preventing thrombocytopenia after chemotherapy in acute leukemia. Methods A total of 56 patients with acute leukemia admitted to Baoji People's Hospital from May 2016 to May 2017 were randomly divided into an observation group and a control group according to the random number table method, with 28 cases in each group. The control group received conventional chemotherapy, and the observation group was treated with irhIL-11 on the basis of the control group; the treatment time was 28 days. After treatment, the lowest platelet counts, the time of platelet recovery to 100×109/L, mean platelet transfusion volume, bleeding, and adverse reaction rates were compared between the two groups. Results There was no significant difference in the lowest platelet count between the observation group and the control group:(8.5±1.6)×109/L vs(8.4±1.9)×109/L, P>0.05. The highest platelet value in the observation group was(167.4±25.3)×109/L, which was significantly higher than(91.8 ± 20.6) × 109/L in the control group(P>0.05). The platelet recovery time in the observation group was significantly shorter than that in the control group:(12.1±5.4) d vs(16.7±6.1) d, P<0.05. The platelet transfusion volume of the observation group was significantly lower than that of the control group:(7.0±3.5) U vs(10.4±3.9) U,P<0.05. Bleeding occurred in 6 patients(21.4%) in the observation group, including 3 cases of skin ecchymosis, 2 cases of mucosal hemorrhage and 1 case of visceral hemorrhage. In the control group, 17 cases(60.7%) showed bleeding, including 9 cases of skin petechia, 6 cases of mucosal hemorrhage and 2 cases of visceral hemorrhage; all differences between the two groups were statistically significant(P<0.05). Conclusion Recombinant human interleukin-11 can prevent thrombocytopenia after chemotherapy in acute leukemia, and can effectively promote platelet production, which is worthy of clinical application.
Objective To investigate the clinical effect of recombinant human interleukin-11(rhIL-11) in preventing thrombocytopenia after chemotherapy in acute leukemia. Methods A total of 56 patients with acute leukemia admitted to Baoji People's Hospital from May 2016 to May 2017 were randomly divided into an observation group and a control group according to the random number table method, with 28 cases in each group. The control group received conventional chemotherapy, and the observation group was treated with irhIL-11 on the basis of the control group; the treatment time was 28 days. After treatment, the lowest platelet counts, the time of platelet recovery to 100×109/L, mean platelet transfusion volume, bleeding, and adverse reaction rates were compared between the two groups. Results There was no significant difference in the lowest platelet count between the observation group and the control group:(8.5±1.6)×109/L vs(8.4±1.9)×109/L, P>0.05. The highest platelet value in the observation group was(167.4±25.3)×109/L, which was significantly higher than(91.8 ± 20.6) × 109/L in the control group(P>0.05). The platelet recovery time in the observation group was significantly shorter than that in the control group:(12.1±5.4) d vs(16.7±6.1) d, P<0.05. The platelet transfusion volume of the observation group was significantly lower than that of the control group:(7.0±3.5) U vs(10.4±3.9) U,P<0.05. Bleeding occurred in 6 patients(21.4%) in the observation group, including 3 cases of skin ecchymosis, 2 cases of mucosal hemorrhage and 1 case of visceral hemorrhage. In the control group, 17 cases(60.7%) showed bleeding, including 9 cases of skin petechia, 6 cases of mucosal hemorrhage and 2 cases of visceral hemorrhage; all differences between the two groups were statistically significant(P<0.05). Conclusion Recombinant human interleukin-11 can prevent thrombocytopenia after chemotherapy in acute leukemia, and can effectively promote platelet production, which is worthy of clinical application.
引文
[1]盖灿,陆跃武. rhIL-11对急性白血病化疗后血小板减少的疗效分析[J].中华全科医学, 2013, 11(7):1071-1072.
[2]胡媛媛,高小见,肖传宇.重组人白介素11治疗急性白血病化疗后血小板减少的临床疗效[J].海南医学, 2017, 28(15):2434-2436.
[3]曾艳,刘羽,谭艳丽,等.白血病化疗后血小板减少症的临床特点及个性化护理体会[J].血栓与止血学, 2016, 22(1):104-106.
[4]付岭,张涛,刘金梅,等.重组人血小板生成素与白介素-11治疗白血病化疗后血小板减少症的疗效比较[J].临床军医杂志, 2014, 42(3):240-242.
[5] MASESHIAMA K, TAKAHASHI T, NAKAHIRA K, et al. A protective role of interleukin 11 on hepatic injury in acute endotoxemia[J].Shock, 2004, 21(2):134-138.
[6]王凤云,孔凡良,蒋英俊,等.重组人白介素-11应用白血病化疗后血小板减少疗效观察[J].安徽医药, 2015, 19(9):1816-1817.
[7]马杉姗,胡成炫,王洪领,等.聚乙二醇化重组人改构白介素11对骨髓抑制的小鼠促血小板生成作用的评价[J].中国实验血液学杂志, 2016, 24(5):1511-1517.
[8]张之南,沈悌.血液病诊断与疗效标准[M]. 3版.北京:科学出版社, 2008:103-123.
[9]王萍,葛守辈,刘晓娟,等.重组人白细胞介素-11治疗急性髓系白血病化疗后血小板减少效果观察[J].中华实用诊断与治疗杂志,2014, 28(3):301-302.
[10] SANO E, TAKEI T, UEDA T, et al. Production and characterization of genetically modified human IL-11 variants[J]. Biochim Biophys Acta, 2017, 1861(2):205-217.
[11]曹静,黄琨,徐敏.重组人白细胞介素-11联合糖皮质激素治疗免疫性血小板减少症的疗效分析[J].国际输血及血液学杂志, 2016, 39(1):4-8.
[12] SOKOLOV AS, KAZAKOV AS, SOLOVYEV VV, et al. Expression,purification, and characterization of interleukin-11 orthologues[J].Molecules, 2016, 21(12):1632-1633.
[13]杨弘,聂波.自体血小板输注与重组人白介素11治疗急性白血病化疗相关性血小板减少的临床疗效研究[J].实用心脑肺血管病杂志, 2013, 21(3):85-86.
[14]李思,洪珞珈,展昭民,等.重组人血小板生成素与白介素-11治疗急性白血病化疗后血小板减少96例的疗效对比观察[J].航空航天医学杂志, 2014, 25(4):433-434.
[2]胡媛媛,高小见,肖传宇.重组人白介素11治疗急性白血病化疗后血小板减少的临床疗效[J].海南医学, 2017, 28(15):2434-2436.
[3]曾艳,刘羽,谭艳丽,等.白血病化疗后血小板减少症的临床特点及个性化护理体会[J].血栓与止血学, 2016, 22(1):104-106.
[4]付岭,张涛,刘金梅,等.重组人血小板生成素与白介素-11治疗白血病化疗后血小板减少症的疗效比较[J].临床军医杂志, 2014, 42(3):240-242.
[5] MASESHIAMA K, TAKAHASHI T, NAKAHIRA K, et al. A protective role of interleukin 11 on hepatic injury in acute endotoxemia[J].Shock, 2004, 21(2):134-138.
[6]王凤云,孔凡良,蒋英俊,等.重组人白介素-11应用白血病化疗后血小板减少疗效观察[J].安徽医药, 2015, 19(9):1816-1817.
[7]马杉姗,胡成炫,王洪领,等.聚乙二醇化重组人改构白介素11对骨髓抑制的小鼠促血小板生成作用的评价[J].中国实验血液学杂志, 2016, 24(5):1511-1517.
[8]张之南,沈悌.血液病诊断与疗效标准[M]. 3版.北京:科学出版社, 2008:103-123.
[9]王萍,葛守辈,刘晓娟,等.重组人白细胞介素-11治疗急性髓系白血病化疗后血小板减少效果观察[J].中华实用诊断与治疗杂志,2014, 28(3):301-302.
[10] SANO E, TAKEI T, UEDA T, et al. Production and characterization of genetically modified human IL-11 variants[J]. Biochim Biophys Acta, 2017, 1861(2):205-217.
[11]曹静,黄琨,徐敏.重组人白细胞介素-11联合糖皮质激素治疗免疫性血小板减少症的疗效分析[J].国际输血及血液学杂志, 2016, 39(1):4-8.
[12] SOKOLOV AS, KAZAKOV AS, SOLOVYEV VV, et al. Expression,purification, and characterization of interleukin-11 orthologues[J].Molecules, 2016, 21(12):1632-1633.
[13]杨弘,聂波.自体血小板输注与重组人白介素11治疗急性白血病化疗相关性血小板减少的临床疗效研究[J].实用心脑肺血管病杂志, 2013, 21(3):85-86.
[14]李思,洪珞珈,展昭民,等.重组人血小板生成素与白介素-11治疗急性白血病化疗后血小板减少96例的疗效对比观察[J].航空航天医学杂志, 2014, 25(4):433-434.