白介素-11在门脉高压症患者的术前应用  

Preoperative application of rhil-11 on improving thrombocytopenia in patients with hepatic cirrhosis

作　　者：方和平[1] 通讯作者：邓美海，通信地址：广州市天河路600号中山大学附属第三医院肝胆外科，邮政编码：510630邓美海 潘卫东[1] 许瑞云[1] 

机构地区：[1]中山大学附属第三医院肝胆外科,广东广州510630

出　　处：《国际医药卫生导报》2008年第22期5-9,共5页International Medicine and Health Guidance News

基　　金：广东省科技计划资助项目（编号：2007B031511007）

摘　　要：目的观察术前应用重组人白介素11（rhIL-11）改善肝硬化伴脾功能亢进患者血小板减少的疗效和安全性，减少围手术期血小板的输注。方法将乙肝肝硬化并脾功能亢进准备行手术治疗的患者（n=45）分成A、B两组，A组（n=23）术前注射rhIL-1150μg／（kg·d），共10天，比较两组血小板计数变化、输注情况、术后血小板增高发生率、肝酶学指标（AST、ALT、TBIL、ALP、LDH、PT）变化、肾功能指标（BUN和肌酐），门静脉血栓（PVT）形成率、不良反应发生率。结果两组血小板基数值无统计学差异，用药后A组血小板计数显著高于B组，A组血小板输注频率及输注量低于B组，两组比较有统计学差异；术后血小板增高发生率A组12．5％，B组16．2％，无统计学差异；术后各项肝酶学指标恢复未受影响；门静脉血栓形成率A纽18．6％，B组21．4％，均无统计学差异；液体潴留、红眼、关节痛、头痛的发生率A组高于B组。结论乙肝肝硬化并脾功能亢进患者术前应用rhIL-11可有效提高血小板计数，减少围手术期血小板输注量，对术后肝功能恢复无显著影响。Objective To observe the efficacy and safety of preoperative application of recombinant human interleukin-ll （rhIL-11） on thrombocytopenia in hepatic cirrhosis patients with bypersplenism and reduce perioperative platelet transfusion. Methods HBV-liver cirrhosis patients combined with hypersplenism （n=45）,who were ready for operation in general surgery, were divided into 2 groups： group A and group B. RhIL-11 [50 μg/（kg-d）] were given in group A （n=23） for 10 d before operation. The platelet count changes, the effect of platelet transfusion, the incidence of platelet increase after operation, changes of liver enzyme indicators （AST, ALT, TBIL, ALP, LDH, PT）, renal function index （BUN and creatinine）, formation rate of portal vein thrombosis （PVT） and the incidence of adverse reactions were compared between the two groups. Results There was no significant difference in the value of platelet radix between the two groups. After treatment, platelet count in group A was significantly higher than that in group B, while frequency and amount of platelet transfusion was lower than that in group B, which had significant differences; the incidence of platelet increase after operation of group A and B were 12.5% and 16.2% respectively, with no statistical difference. The resumption of each liver enzyme indicator was not affected; the formation rate of portal vein thrombosis in two groups were 21.4% and 18.6%, respectively, without significant difference; However, the incidence of fluid retention, red-eye, joint pain, headache in group A was higher than that of group B. eonelusion Preoperative application of rhIL-11 in HBV-liver cirrhosis patients combined with hypersplenism before operation can effectively increase the platelet count, reduce perioperative platelet transfusion and have no significant impact on restoration of liver function after operation.

关 键 词：重组人白介素-11 肝硬化 血小板减少 脾切除术 

分 类 号：R657[医药卫生—外科学]